Significance of hemorrhage into brain tumors: clinicopathological study

Douglas KondziolkaDivisions of Neurosurgery and Neuropathology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

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Mark BernsteinDivisions of Neurosurgery and Neuropathology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

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Lothar ReschDivisions of Neurosurgery and Neuropathology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

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Charles H. TatorDivisions of Neurosurgery and Neuropathology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

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J. F. Ross FlemingDivisions of Neurosurgery and Neuropathology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

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R. G. VanderlindenDivisions of Neurosurgery and Neuropathology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

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Hart SchutzDivisions of Neurosurgery and Neuropathology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

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Page Range:
852–857
Volume/Issue:
Volume 67: Issue 6
DOI link:
https://doi.org/10.3171/jns.1987.67.6.0852
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✓ A retrospective clinical and pathological review of 905 consecutive brain tumor cases (excluding pituitary adenoma and recurrent tumor) was conducted to identify cases in which intratumoral hemorrhage was confirmed grossly and/or pathologically. There were 132 cases so identified, for an overall tumor hemorrhage rate of 14.6%; of these, 5.4% were classified as macroscopic and 9.2% as microscopic. The presence of hemorrhage was correlated with the neurological presentation. The highest hemorrhage rate (70.0%) was found in patients with prior neurological history who experienced apoplectic deterioration (acute-on-chronic presentation). Only 57.1% of patients with acute deterioration in the absence of prior neurological symptoms had hemorrhages. The highest hemorrhage rate for primary brain tumors was 29.2% for mixed oligodendroglioma/astrocytoma, while the highest hemorrhage rate for any tumor type was 50% for metastatic melanoma. The clinical relevance of tumor hemorrhage is discussed.

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Address reprint requests to: Mark Bernstein, M.D., F.R.C.S.(C), 25 Leonard Avenue, Suite 211, Toronto, Ontario M5T 2R2, Canada.
Keywords:
brain neoplasm; intratumoral hemorrhage; apoplexy
Page Count:
6
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