Spinal schwannoma and ependymoma: a diagnosis that shouldn't be missed in SAH – literature review and case report
Argiti K, Fung C, Shah MJ, Vasilikos I, Schnell O, Beck J, Rahal AE (2023)
Publication Type: Journal article, Review article
Publication year: 2023
Journal
Book Volume: 69
Article Number: 101495
Journal Issue: 6
DOI: 10.1016/j.neuchi.2023.101495
Abstract
Background: The incidence of subarachnoid hemorrhage (SAH) is around 9/100 000 people annually, with 15–37% having no identifiable vascular source on angiography. This study aimed to define criteria to identify patients with a possible spinal origin of SAH. We present a literature review and a case of a 61-year-old patient with SAH due to lumbar spinal schwannoma. Methods: A literature search and review were conducted according to the PRISMA-P 2020 guidelines. We performed a restricted search using the keywords “SAH” and “Spinal Schwannoma”; “SAH” and “Ependymoma”. Results: Out of 297 articles, 32 were included between 1951 and 2023 for a total of 44 cases with SAH of spinal origin. Fourteen schwannomas (31.8%) and 30 ependymomas (68.2%) were included in the review. Men represented 77% of the schwannoma and 64% of the ependymoma cohort. The median age was 45 years in the schwannoma vs 29 years in the ependymoma group. Ependymomas were predominantly located in the lumbar spine (85%). Localised spinal symptoms were present in 65% of schwannoma cases, encompassing radicular pain (28%), motor deficit (22%), and incontinence (14.5%). This was 93% in ependymomas, with symptoms being radicular pain (40%), motor deficit (20%), and incontinence (17%). Lumbar punctures diagnosed 86.5% of SAHs, while only 18.2% had subarachnoid bleeding found on a cerebral CT or MRI. Conclusion: In SAH patients lacking a vascular bleeding source, any spinal symptom must prompt a complete examination of the spinal axis (i.e. MRI). Without spinal symptoms, SAH associated with spinal tumors will likely be missed.
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Germany (DE)How to cite
APA:
Argiti, K., Fung, C., Shah, M.J., Vasilikos, I., Schnell, O., Beck, J., & Rahal, A.E. (2023). Spinal schwannoma and ependymoma: a diagnosis that shouldn't be missed in SAH – literature review and case report. Neurochirurgie, 69(6). https://doi.org/10.1016/j.neuchi.2023.101495
MLA:
Argiti, Katerina, et al. "Spinal schwannoma and ependymoma: a diagnosis that shouldn't be missed in SAH – literature review and case report." Neurochirurgie 69.6 (2023).
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