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Cerebral neoplasms initially presenting with massive intracerebral hemorrhage
Surgical Neurology
|July 1, 1984
Summary
Clinically silent brain tumors can cause severe intracerebral hemorrhage. These rare cases highlight the importance of considering neoplastic causes for unexplained hemorrhages, even without prior tumor evidence.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Intracerebral hemorrhage (ICH) is often associated with hypertension or vascular malformations.
- Brain tumors are a less common cause of ICH, particularly when clinically silent.
Observation:
- Three patients presented with massive ICH due to previously undiagnosed brain tumors.
- Computed tomography and angiography did not initially suggest the presence of neoplasms.
- These cases represented 0.6% of brain tumor patients and 2.5% of ICH patients.
Findings:
- Histological examination confirmed metastatic bronchogenic carcinoma, metastatic clear-cell carcinoma, and low-grade astrocytoma in the three patients.
- The tumors were clinically silent prior to the hemorrhagic event.
Implications:
- Undiagnosed brain tumors should be considered in the differential diagnosis of spontaneous ICH, especially when imaging is inconclusive.
- Early detection of silent tumors causing hemorrhage can improve patient outcomes.
- Further research may elucidate the mechanisms by which silent tumors precipitate ICH.