Hemangioblastoma presenting with intraparenchymatous hemorrhage

The authors report six cases of hemangioblastoma presenting with apoplectic symptoms but with no history related to the tumor. In each case, computerized tomography disclosed an intraparenchymatous hemorrhage, which was located supratentorially in four and in the cerebellum in the remaining two. Angiography revealed an abnormal vascular blush in two cases, but no abnormal vessels or tumor blush in the other four. In all cases, a solid tumor with abnormal vessels, such as red veins and feeding arteries, was found within or adjacent to the hemorrhage at surgery. The possibility of hemangioblastoma should be kept in mind as a cause of intraparenchymatous hemorrhage, particularly subcortical. Evacuation of the hematoma should be carefully carried out, and the whole hematoma wall should be thoroughly investigated for abnormal vessels or a solid mass.