gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Chronic recurrent subarachnoid hemorrhage from a malignant trigeminal peripheral nerve sheath tumour

Rezidivierende Subarachnoidalblutung bei malignem peripheren Nervenscheidentumor des Nervus Trigeminus

Meeting Abstract

  • corresponding author A.M. Stark - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • R. Buhl - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • T. Straube - Sektion Neuroradiologie im Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • H.M. Mehdorn - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 09.123

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Stark et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Clinically significant subarachnoid bleeding from trigeminal nerve tumors is very rare.

Methods: We report the case of a 59-year old patient who presented with subarachnoid hemorrhage caused by intratumoral bleeding of a malignant peripheral nerve sheath tumor of the left trigeminal nerve.

Results: The patient presented with decreased consciousness, left facial hypesthesia and left facial weakness. The patient was known to suffer from trigeminal neuralgia since 18 months. Cranial Computed Tomography and Magnetic Resonance Imaging revealed a left parapontine mass with cystic changes and intratumoral bleeding. Furthermore, signs of hemosiderosis were noted. Lumbar Puncture revealed fresh bleeding. Angiography detected no aneurysm or other causes of bleeding. The patient became fully alert within hours, the facial weakness improved within few days. There was no evidence of vasospasm or persisting hydrocephalus. The patient underwent left-sided suboccipital craniotomy for macroscopically total tumor removal. Intraoperatively, evidence of recurrent intratumoral and peritumoral bleeding was noted. Histological examination revealed MPNST (WHO grade III). Postoperatively, hypesthesia improved significantly. The patient was transferred to radiotherapy for external beam radiation.

Conclusions: This is the first report about a Malignant Peripheral Nerve Sheath Tumor of the trigeminal nerve which caused clinically significant subarachnoid hemorrhage due to intratumoral bleeding.