Spontaneous intracranial haematomas caused by neoplasms

Acta Neurochir (Wien). 2000;142(9):979-85. doi: 10.1007/s007010070052.


We report about 50 patients with spontaneous intracerebral haematomas (ICH) caused by intracranial neoplasms to assess the underlying histological condition, their presentation on admission, diagnostic work-up, treatment, histological diagnosis, and clinical outcome. These patients were identified in a prospective series of 2041 patients with intracranial neoplasms and 692 patients with spontaneous ICH, which were both consecutively collected over a nine-year-period. The frequency of ICH in patients with intracranial neoplasms was 2.4%. The frequency of tumour related ICH in the ICH group was 7.2%. The leading cause of tumour related ICH were metastases of extracranial origin (n = 18; 36%), followed by glioblastoma multiforme (n = 15; 30%). Nine patients (18%) had benign primary intracranial neoplasms. On admission 18 patients were somnolent (36%) and 14 patients (28%) were comatose. In 29 cases (58%) ICH was the first clinical sign of neoplastic disease, while in 21 patients (42%) a malignant tumour was already known. We operated on 45 patients (90%), four patients (8%) were not operated on because of poor clinical condition and died, one patient refused surgical treatment. Six patients (12%) died despite surgery. This series confirms the importance of a proper neuroradiological and clinical work-up of patients with suspected tumour related ICH followed by operative treatment and histological confirmation of the diagnosis. This is supported by the fact that 18% of patients had prognostically favourable intracranial tumours which would not otherwise have been adequately treated.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / complications*
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / epidemiology
  • Brain Neoplasms / surgery
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Hematoma / diagnostic imaging
  • Hematoma / etiology*
  • Hematoma / surgery
  • Humans
  • Infant
  • Intracranial Hemorrhages / diagnostic imaging
  • Intracranial Hemorrhages / etiology*
  • Intracranial Hemorrhages / surgery
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Prospective Studies
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Treatment Outcome