[Tumor hemorrhage in intracranial tumors]

From 1975 to 1981, 50 patients with spontaneous hematomas due to intracranial tumours were treated in the Neurochirurgische Universitätsklinik Erlangen-Nürnberg. 33 tumours were located within the cerebral hemispheres, 6 within the oral brain stem, 6 tumours had a cerebellar origin, 2 neoplasms were located within the cerebellopontine angle, and 3 tumours grew in the sellar region. In most of the patients we found metastatic neoplasms (26%) and glioblastomas (22%), 6 tumours (12%) could not be identified histologically; 2 of these cases were assumed to be malignant gliomas. Two congenital tumours and a chondroma of the cerebellopontine angle were particularly notable. The incidence of tumour hemorrhage reported here was 4.1%. In 40 patients (80%) the hemorrhage was the cause of an acute clinical course, leading to death in 10 cases. 30% of the patients had to be operated on immediately, 32% were primarily treated in the intensive-care unit. Ten patients of the latter group died because of the acute hemorrhage. In the remaining 19 patients the course appeared to be less threatening and generally of an apoplectiform type. In about 50% the hemorrhage represented the first reliable sign of the hitherto asymptomatic tumour growth, in 32% it remained the only clinical diagnosis for a certain time. In 3 patients the brain tumours were not definitely diagnosed until some months later. One tumour was identified at autopsy. In pathological anatomy we could differentiate between several types of tumour bleedings. CT scan enabled the identification of the neoplastic origin in 86%, in 5 cases (10%) CT failed to yield the correct diagnosis. Twice CT scan had not been performed.(ABSTRACT TRUNCATED AT 250 WORDS)