title: Spontaneous intracranial haematomas caused by neoplasms.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Christian-Albrechts-Universität, Kiel, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Schrader
authors.forename: H
authors.initials: H
authors.lastname: Barth
authors.forename: E W
authors.initials: EW
authors.lastname: Lang
authors.forename: R
authors.initials: R
authors.lastname: Buhl
authors.forename: H H
authors.initials: HH
authors.lastname: Hugo
authors.forename: J
authors.initials: J
authors.lastname: Biederer
authors.forename: H M
authors.initials: HM
authors.lastname: Mehdorn
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007223:Infant; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome