Significance of hemorrhage into brain tumors: clinicopathological study

Douglas Kondziolka M.D.1, Mark Bernstein M.D., F.R.C.S.(C)1, Lothar Resch M.D., F.R.C.P.(C)1, Charles H. Tator M.D., F.R.C.S.(C)1, J. F. Ross Fleming M.D., F.R.C.S.(C)1, R. G. Vanderlinden M.D., F.R.C.S.(C)1, and Hart Schutz M.D., F.R.C.S.(C)1
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  • 1 Divisions of Neurosurgery and Neuropathology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
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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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