title: Diffuse astrocytoma initially presenting as a massive intracerebral hemorrhage: case report.
abstract: We report the case of a 58-year-old woman with low-grade astrocytoma, who developed massive intracranial hemorrhage as the first presentation of this disease, and become comatose and subsequently underwent an emergency craniotomy. A small amount of tumor-like tissue was observed on the wall of the hematoma cavity. Histological analysis of the resected specimen indicated diffuse astrocytoma [World Health Organization (WHO) grade II]. The patient was discharged without neurological deficits 2 weeks after the operation. A non-enhanced tumor-like nodule was observed on magnetic resonance imaging 3 months after the operation, which was monitored carefully but was not treated by adjuvant therapy. The tumor grew gradually, and a second operation was performed 3 years after the first, in which the tumor was completely resected. Histological analysis of the resected specimen again indicated diffuse astrocytoma (WHO grade II). Although rare, brain tumors, including low-grade astrocytoma, should be considered a possible cause of subcortical hemorrhage in patients without risk factors for intracranial hemorrhage.
authors.affiliation: Department of Neurosurgery, Hamamatsu University School of Medicine.
authors.forename: Takao
authors.initials: T
authors.lastname: Nozaki
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sato
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yamazoe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Namba
mesh_terms: D001254:Astrocytoma / Q000150:complications* / Q000601:surgery; D001932:Brain Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D012307:Risk Factors