Giant Hemorrhagic Cervical Schwannoma in a Young Woman with Acute Quadriparesis: Case Report

Background: Schwannomas are the most common extramedullary spinal tumors. The acute hemorrhagic onset of a spinal schwannoma is a rare occurrence. Case report: We report the case of a 32-year-old woman who presents with acute onset of quadriparesis due to a hemorrhagic intradural schwannoma. The tumor arose from left C1-C2 roots and extended downward from C1 to C5 vertebral levels. An emergency posterior osteoplastic laminotomy extending from C2 to C4 was performed anden bloc resection of the tumor was achieved. Histological diagnosis was schwannoma with hemorrhagic components. Discussion: A spinal intradural hemorrhage related to a schwannoma is a very rare occurrence, and intralesional hemorrhage is most frequently associated with tumors located in the conus medullaris and cauda equine. Conclusion: Early diagnosis and management in cervical pathologies with acute neurologic manifestations is crucial. An intradural hemorrhagic event should be suspected in cases of acute onset of symptoms, even in patients without coagulopathies.