Brain hemorrhage from intracranial tumor

Brain hemorrhage from an intracranial tumor was encountered in 7 males and 6 females during a 4-year period. In 5 patients, hemorrhage was responsible for the first signs of a previously unsuspected neoplasm. The intracranial lesion was demonstrated by computed tomography (CT scanning) in each patient. Characteristic CT scan findings included: a neoplastic core (high or low density); small, multifocal clots usually at the margin of the tumor; and, surrounding, often extensive, edema. Enhancement of the tumor tissue with intravenous injection of 60% Hypaque was observed in the 8 patients so studied. The regions which were enhanced had a peripheral distribution corresponding to the site of hemorrhage. Microscopic examination demonstrated 7 glioblastoma multiforme, 1 oligodendroglioma, 4 metastatic carcinomas (including 1 each of bronchogenic carcinoma, melanoma, hypernephroma, and adrenal carcinoma), and 1 hemangiopericytoma. High-grade malignancy and extensive, abnormal vascularity appeared to be predisposing factors.