Vestibular schwannomas are prone to intratumoral hemorrhage. This results in a number of clinical findings that may be termed acoustic apoplexy (Hollingsworth et al).
Clinical findings may include the acute onset of:
(1) vomiting
(2) headache
(3) vertigo or dysequilibrium
(4) sensorineural hearing loss (cranial nerve VIII)
(5) other cranial nerve palsies (facial nerve, abducens nerve)
(2) oral anticoagulation or other hypocoagulable state
The diagnosis is usually made by imaging studies that show acute hemorrhage within the tumor. More severe episodes may be complicated by subarachnoid hemorrhage.
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