[Intracerebral bleeding as the first symptom of a congenital anaplastic astrocytoma]

Anaplastic astrocytomas in neonates are extremely rare. Newborns, however, often have neuroectodermal central nervous tumours.

We report about a female term newborn (birth weight 3,600 g, APGAR 9/10/10), who had shrill screams, intermittent shivering and bradycardia. An ultrasound scan of the brain showed an intracerebral bleeding. Therefore, the child was transferred to the intensive care unit of our hospital. A CT scan showed cerebral bleeding in the left parieto-occipital region, partially clotted, with a space-demanding effect. The intracerebral bleeding in the left occipital region was cleared out. No tumour was found, but an anaplastic astrocytoma (WHO Grade III) was diagnosed histologically. Serial ultrasound investigations of the brain showed a normal midline and a redevelopment of the left-sided ventricle. After surgery no tumour was visible in the MRI. Six weeks later, a tumour was found in the area of the initial bleeding region on MRI.

Congenital anaplastic astrocytomas have a variable outcome, with different survival rates as compared to adults. In the literature, survival rates of 36-50 % were found after complete tumour resection. In cases of neonatal intracerebral bleeding, a tumour might be the cause of the haemorrhage.