Hemorrhagic Necrotic Schwannoma Presenting as Purulent Meningitis

H.C. Onyiuke, A. McLean, M. Schwartz, M. Louie and L.C. Ang

Abstract: Background: Intracranial schwannoma involving the XIIth cranial nerve is rare. We report an unusual clinical presentation and pathological verification of a schwannoma, which had become haemorrhagic and necrotic, simulating acute purulent meningitis. Methods: A literature review of intracranial tumors presenting as acute purulent meningitis, with emphasis on schwannomas, was undertaken. Results: Few cases of hypoglossal schwannoma have been reported; the association with purulent meningitis has not been previously documented. Conclusion: In patients presenting with sterile purulent meningitis, a necrotic tumor should be considered as a possible etiology.

Can. J. Neurol. Sci. 1998; 25: 164-167