BACKGROUND Subarachnoid hemorrhage (SAH) with a spinal origin is a rar
e clinical entity. The most common source of SAH is an arteriovenous m
alformation. Only six cases of spinal hemangioblastomas causing SAH ha
ve been reported. CASE DESCRIPTION This 48-year-old man had experience
d severe headache 12 years earlier, which was diagnosed as SAH by comp
uted tomography (CT) scan and lumbar puncture. However, cerebral angio
graphy could not detect either aneurysm or arteriovenous malformation.
Thereafter, he spent an uneventful life until he was incidentally dia
gnosed with a cervical tumor on magnetic resonance imaging (MRI) study
for Meniere's disease. The tumor was situated at the cervicomedullary
junction, and fed by the left vertebral artery. Histologic findings o
f the tumor showed features typical of hemangioblastoma. CONCLUSIONS W
e describe a case of cervical spinal extramedullary hemangioblastoma w
ith a past history of SAH. In our case, the SAH of 12 years ago perhap
s occurred from the cervicomedullary junction hemangioblastoma. Since
the etiology of SAH could not be detected at the first angiography, no
t only follow-up reangiography, but also MRI of the spinal cord and sp
inal angiography could have played an important role. (C) 1998 by Else
vier Science Inc.