1. Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology Intracranial mass presenting with hemorrhage and respiratory failure

2. Vignette A 30 year-old male presented after sudden severe headache and subsequent loss of consciousness. He was intubated with GCS 3 and apnea. CT showed acute hemorrhage in the posterior fossa with brainstem compression and extension of hemorrhage into the fourth ventricle with early obstructive hydrocephalus (Figure 1A). This was relieved with external ventricular drain insertion. Rizek et al. © 2013 American Academy of Neurology

3. Imaging Rizek et al. © 2013 American Academy of Neurology

4. Imaging Rizek et al. © 2013 American Academy of Neurology

5. Large vagal nerve schwannoma presenting with hemorrhage and respiratory failure Lower cranial nerve schwannomas constitute 3% of all intracranial schwannomas; purely intracranial vagal schwannomas are particularly infrequent. 1 Intratumoral and subarachnoid hemorrhage rarely occur with schwannomas. 2 Rizek et al. © 2013 American Academy of Neurology