Intracerebral hematoma simulating a new growth.

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Intracerebral hematomas can present with varied clinical and radiological features.
• Differentiating hematomas from brain tumors is crucial for appropriate management.

Observation:

• Three patients presented with slowly progressive neurological deficits.
• Computed tomography (CT) scans showed ring-enhancing intracerebral mass lesions with midline shift.
• Angiography revealed avascular mass lesions.

Findings:

• Surgical exploration identified soft, well-encapsulated, organized intracerebral hematomas.
• These hematomas contained both fresh and old hemorrhages.
• A feeding artery on the capsule of the hematoma was identified in each case.

Implications:

• The findings suggest a pathogenesis involving continuous bleeding from a feeding artery, leading to hematoma expansion.
• This process can mimic the clinical and radiological presentation of intracerebral neoplasms.
• Accurate diagnosis requires consideration of organized hematomas in the differential diagnosis of ring-enhancing brain lesions.