Intratumoral Bleeding in a Vestibular Schwannoma

Vestibular schwannomas (VSs) account for approximate to 70% of all tumors of the cerebellopontine angle (CPA). Their clinical presentation is often insidious, with progressive hearing loss and involvement of other cranial nerves. Spontaneous hemorrhage in those tumors is very unusual, and generally presents with acute clinical features such as nausea, vomiting, headache and altered consciousness, usually with marked dysfunction of the cranial nerve involved, and with new deficits of neighboring cranial nerves. Asymptomatic patients are extremely rare. We present a case report of an incidental VS with asymptomatic bleeding, which evolved to death after surgery. Resumo Schwannomas vestibulares (SVs) sAo responsaveis por cerca de 70% de todos os tumores do angulo pontocerebelar. Sua apresentacAo costuma ser insidiosa, com perda auditiva progressiva e envolvimento de outros nervos cranianos. Hemorragia espontanea nesses tumores e incomum, e geralmente apresenta-se agudamente, com nausea, vomitos, cefaleia e alteracoes de consciencia, normalmente com disfuncAo importante dos nervos cranianos envolvidos e com novos deficits dos nervos proximos. Pacientes assintomaticos sAo extremamente raros. Apresentamos um relato de caso de um SV incidental com sangramento assintomatico que evoluiu para o obito apos cirurgia.