Subarachnoid haemorrhage (SAH) incidence is approximately 9/100 000 person-years but varies according to location, age, and sex [1]. In a recent meta-analysis, this incidence is nowadays estimated to be worldwide at 6.1/100 000 person-years [2]. Non-aneurysmal SAH (NASAH) is a well-established entity, and no bleeding source can be identified in 15–37% of cases despite repeated radiological imaging and at least two digital subtraction angiography examinations, one of which should be performed no earlier than three weeks after the bleeding [3], [4], [5], [6], [7].

Further diagnostics in patients with angionegative SAH can be challenging and not standardised. Rarely is spinal pathology the cause of SAH (0.5–1% of cases) [8], [9], [10].

Usually, the origin of spinal subarachnoid bleeding is a vascular malformation and rarely a tumorous origin. SAH due to spinal schwannoma or ependymoma is very rare, and only a few cases have been reported in the recent era. However, this aetiology should be considered in patients with typical symptoms of aneurysmal SAH, such as sudden headache, nuchal rigidity, and negative findings on angiography.

This study aimed to define criteria to identify patients with a possible spinal tumorous origin of SAH. Therefore, we conducted a literature review illustrated by a case of a 61-year-old patient with SAH due to spinal schwannoma treated in our institution.