Abstract
The initial presentation of brain tumors will depend especially on their location, adjacent structures or in some cases may have an asymptomatic course. However, one of the rare but well-known causes of spontaneous intracraneal hemorrhages is the initial presentation of primary and secondary brain tumors. This article presents the case of a 72-year-old patient who has entered to the emergency department with altered consciousness state and left brachio-crural hemiparesis, the patient in the vital signs has presented high-tension rates. The cranial CT has shown a space occupying lesion with mass effect and characteristics suggesting intratumoral hemorrhage that required drainage and resection of the extra-axial tumor. The result of the pathology revealed an atypical meningioma grade II.
References
Qureshi AI, Tuhrim S, Broderick JP, Batjer H, Hondo H, Hanley D. Spontaneous intracerebral hemorrhage. N Eng J Med. 2001;344:1450-60. doi: 10.1056/NEJM200105103441907.
Mandybur TI. Intracranial hemorrhage caused by metastatic tumors. Neurology. 1977;27(7):650-5. doi: 10.1212/wnl.27.7.650.
Nutt S, Patchell R. Intracranial hemorrhage associated with primary and secondary tumors. Neurosurg Clin N Am. 1992;3(3)591-9.
Chonan M, Mino M, Yoshida M, Sakamoto K. Brain metastasis from papillary thyroid carcinoma with acute intracerebral hemorrhage: a surgical case report. No Shinkei Geka. 2012;40(5):453-7.
Kondziolka D, Bernstein M, Resch L, Tator C, Fleming R, Vanderlinden RG, et al. Significance of hemorrhage into brain tumors: clinicopathological study. J Neurosurg. 1987;67:852-7.
Zeng C, Tang S, Jiang Y, Xiong X, Zhou S. Seven patients diagnosed as intracranial hemorrhage combined with intracranial tumor: case description and literature review. Int J Clin Exp Med. 2015;8(10):19621-5.
Wakai S, Yamakawa K, Manak S, Takakura K. Spontaneous intracranial hemorrhage caused by brain tumor: its incidence and clinical significance. Neurosurgery. 1982;10(4):437-44. doi: 10.1227/00006123-198204000-00004.
Bosnjak R, Derham C, Popovic M, Ravnik J. Spontaneous intracranial meningioma bleeding: clinicopathological features and outcome. J Neurosurg 2005;103(3):473-84. doi: 10.3171/jns.2005.103.3.0473.
Pressman E, Penn D, Patel N. Intracranial hemorrhage from a meningioma: two novel risk factors. World Neurosurg. 2020;135:217-21.9.doi: 10.1016/j.wneu.2019.10.173.
Nobuhiko A, Katsusiro M, Horiguchi T, Akiyama T, Takahashi S, Kaoru Y, et al. Novel method to evaluate the risk of tumor adhesions and post-operative hemorrhage of meningiomas using 320 row CT-DSA: A clinical research study. Acta Neurochir (Wien). 2020;162(9):2145-53. 10. doi: 10.1007/s00701-020-04295-9.
Hu W, Xin Y, Chen X, Song Z, He Z, Zhao Y Tranexamic acid in cerebral hemorrhage: a meta-analysis and systematic review. CNS Drugs. 2019;33(4):327-36. doi: 10.1007/s40263-019-00608-4.
Cornelius JF, Slotty PJ, Steiger HJ, Hanggi D, Polivka M, George B. Malignant potential of skull base versus non-skull base meningiomas: clinical series of 1,663 cases. Acta Neurochir (Wien). 2013;155(3):407-13. doi: 10.1177/0145561320905731.
Gerlach R, Raabe A, Scharrer I, Meixensberger J, Seifert V. Postoperative hematoma after surgery for intracranial meningiomas: Causes, avoidable risk factors and clinical outcome. Neurol Res. 2006;26(1):61-6.13. doi: 10.1179/016164104773026543.
Guo S, Gerganov V, Giordano M, Samii A, Samii M. Elderly patients with frontobasal and suprasellar meningiomas: safety and efficacy of tumor removal via frontolateral approach. World Neurosurg. 2020;135:e452-8. doi: https://doi.org/10.1016/j.wneu.2019.12.029.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.