Diagnosis Angiomatous acoustic neuroma

Problems and Tactics A large hypervascular acoustic neuroma was identified in a young man. Two attempts at resection were truncated by sudden vascular engorgement and parenchymal swelling that collapsed the operative corridor and made hemostasis difficult. Rapid redistribution of blood during tumor resection may have contributed to these developments, akin to the normal perfusion pressure breakthrough seen in resection of arteriovenous malformations (AVMs). Surgical strategies typically used for AVMs and hemangioblastomas were useful in the management of this lesion.

Keywords Acoustic neuroma, vestibular schwannoma, hypervascular, tumor