Rapid Clinical Deterioration of a Patient with a Posterior Fossa Hemangioblastoma and Extensive Cerebellar Ischemia: Report of a Unique Case.

Abstract

Hemangioblastomas are rare, benign, highly vascularized tumors, which among other locations arise in the central nervous system. Due to the tumor's dense vascularity, bleeding and interference with the surrounding brain tissue and vasculature have been reported. Rapid neurological deterioration due to hemorrhage from a hemangioblastoma, especially in spinal locations, has been reported.Rapid clinical deterioration occurred in a 47-year-old male patient with a cerebellar hemangioblastoma and delayed extensive cerebellar ischemia, consecutively. Initial cranial magnetic resonance imaging revealed the tumor with small ischemic areas in the left cerebellar hemisphere. A couple of days later, consciousness dropped significantly and immediate computed tomography revealed extensive ischemia of the left cerebellar hemisphere. Emergency suboccipital decompressive craniectomy and tumor resection were performed. The patient recovered and was discharged to neurological rehabilitation a couple of weeks later.Despite the benign character of hemangioblastomas, life-threatening rapid deterioration due to cerebellar ischemia can occur as reported in this case.