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Multiple progressive intracerebral hemorrhages due to an angiosarcoma: a case report
M Mühlau1, J Schlegel, H G Von Einsiedel
1Department of Neurology, Technical University of Munich, Munich, Germany. mtwoke7@t-online.de
European Journal of Neurology
|December 4, 2003
Summary
This case study highlights a rare cause of recurrent intracerebral hemorrhage (ICH) in a patient on anticoagulation. Autopsy revealed angiosarcoma, emphasizing the need to consider uncommon diagnoses when ICH progresses despite normal coagulation tests.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Intracerebral hemorrhage (ICH) diagnosis and etiology are common clinical challenges.
- Rare causes of ICH pose diagnostic difficulties, especially in patients with confounding factors like anticoagulation.
Observation:
- A patient on oral anticoagulation presented with multiple, progressive ICHs.
- Initial coagulation tests were normal, and no signs of malignancy were apparent.
- ICH progression continued even after coagulation parameters normalized.
Findings:
- Autopsy revealed an angiosarcoma as the underlying cause of the multiple, progressive ICHs.
- This represents a previously undescribed presentation of angiosarcoma primarily affecting the brain.
Implications:
- The case underscores the importance of considering rare etiologies for ICH, particularly when the condition progresses despite seemingly normal coagulation.
- Persistent ICH progression, even with normal coagulation tests, warrants a thorough investigation beyond common causes like anticoagulation therapy.