Spinal schwannoma presenting with intraspinal hematoma: a case report and review of the literature

Spinal schwannomas presenting with an intraspinal hematoma or subarachnoid hemorrhage are extremely rare, and patients often have severe spinal cord compression symptoms. However, the mechanism underlying the bleeding remains unclear.

We present the case of a 53-year-old Chinese female diagnosed with a T12 schwannoma accompanied by an intratumoral hematoma. The patient suddenly experienced unbearable pain in the lower limbs. An emergency operation was necessary, and during surgery, we resected a tumor and evacuated a hematoma. We found a spinal nerve root fracture, intratumoral congestion, tumor capsule rupture, and bleeding. Pathological analysis indicated a schwannoma.

Injury to the nerve roots and vessels during motion, nerve root torsion, twisting, venous obstruction, tumor congestion, swelling, and capsule rupture are important processes in spinal schwannoma hemorrhage. Early diagnosis and proactive surgery are key points for treatment.