Intracranial malignant glioma presenting as subarachnoid hemorrhage.
OBJECTIVE
Cerebral aneurysms are the predominant cause of spontaneous subarachnoid hemorrhage (SAH). However, if an aneurysmal cause has been excluded, there remains but a short list of other potential etiologies. Cerebral neoplasms are clearly on this list but are most commonly meningiomas or metastatic lesions. This article details a case of a neoplasm that presented exclusively with SAH.


METHODS
A 40-year-old male presented with a SAH with normal cerebral angiography. The initial magnetic resonance image revealed a lesion in the right insula thought to be resolving hemorrhage. Subsequent images, however, revealed the mass to be enlarging.


METHODS
Craniotomy and resection of the lesion established a diagnosis of a malignant oligodendroglioma.


CONCLUSIONS
An affirmation is made that patients experiencing 'angiographically-negative' SAH should undergo MRI, occasionally on a serial basis, to exclude other etiologies for hemorrhage, including neoplasia.
Hentschel
Stephen
S
Department of Surgery, Division of Neurosurgery, Vancouver Hospital and Health Sciences Centre, University of British Columbia, Vancouver, BC Canada.
Toyota
Brian
B
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D002533:Cerebral Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D009837:Oligodendroglioma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D012640:Seizures / Q000188:drug therapy / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000209:etiology*
D000927:Anticonvulsants