title: Hemorrhagic Pilocytic Astrocytomas in Adults: A Case Report and Literature Review.
abstract: Pilocytic astrocytomas are histologically benign tumors, generally found in the pediatric population. Onset of symptoms is generally insidious, predominantly stemming from mass effect upon nearby structures. Patients harboring a pilocytic astrocytoma may present with gait disturbance, headaches, cranial nerve deficits, as well as hydrocephalus, depending on the exact location. Although cases of adult pilocytic astrocytomas in the adult population are described, they are quite uncommon. We present a case of an adult female presenting with acute neurological compromise resulting from an acutely hemorrhagic posterior fossa pilocytic astrocytoma. Her initial neurological assessment was consistent with a Glasgow coma scale of 4T, as the patient was experiencing decerebrate posturing. An emergent external ventricular drain was placed in the emergency department for acute hydrocephalus as a temporizing measure, prior to evacuation of the associated subdural and intratumoral hemorrhages, as well as resection of the mass. After a long hospital course and extensive rehabilitation, the patient made a remarkable recovery and eventually gave birth to a child via Caesarean section three years after her initial presentation.
authors: Neurosurgery, SUNY Upstate Medical University.
authors: Michael A
authors: MA
authors: Galgano
authors: Crouse Neuroscience Institute, Crouse Medical Practice, PLLC.
authors: David J
authors: DJ
authors: Padalino
authors: Pathology, SUNY Upstate Medical University.
authors: Joseph
authors: J
authors: Fullmer
authors: Neurosurgery, SUNY Upstate Medical University.
authors: Satish
authors: S
authors: Krishnamurthy
keywords: hemorrhagic pilocytic astrocytoma; hemorrhagic tumor; intratumoral hemorrhage; neurological compromise; pilocytic astrocytoma; subdural hematoma; suboccipital craniotomy; tumor resection