Background: Intracranial schwannoma involving the XIIth cranial nerve is rare. We report an unusual clinical presentation and pathological verification of a schwannoma, which had become haemorrhagic and necrotic, simulating acute purulent meningitis.
Methods: A literature review of intracranial tumors presenting as acute purulent meningitis, with emphasis on schwannomas, was undertaken.
Results: Few cases of hypoglossal schwannoma have been reported; the association with purulent meningitis has not been previously documented.
Conclusion: In patients presenting with sterile purulent meningitis, a necrotic tumor should be considered as a possible etiology.