title: Glioblastoma Multiforme with Hemorrhage Mimicking an Aneurysm: Lessons Learnt.
abstract: BACKGROUND
  A sudden onset of neurological symptoms in patients is conventionally thought to be due to vascular phenomenon, with one common differential diagnosis being subarachnoid hemorrhage. Another important differential diagnosis is ischemic stroke. An uncommon cause of such acute symptoms can be hemorrhage in a pre-existing tumor, that is, intratumoral hemorrhage (ITH).
  
  
  OBJECTIVE
  ITH is an important, though uncommon differential diagnosis in cases of sudden onset of neurological deterioration.
  
  
  RESULTS
  A 60-year-old male presented with seizures and loss of consciousness 12 h prior to admission. The episode was sudden in onset. After detailed clinical and radiological investigations, the patient was diagnosed with glioma with bleed and was successfully operated upon.
  
  
  CONCLUSIONS
  The combination of hemorrhage and ischemic stroke pointed more towards an aneurysm rather than a tumor bleed. There were pointers both in favor of and against both the diagnosis. Therefore, a complex hemorrhagic cerebral tumor with acute presentation and discordant finding on CT or CT angiography should be characterized preoperatively. A large thrombosed aneurysm remains an important differential diagnosis.
authors: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Navneet
authors: N
authors: Singla
authors: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Ashish
authors: A
authors: Aggarwal
authors: Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Sameer
authors: S
authors: Vyas
authors: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Ankur
authors: A
authors: Sanghvi
authors: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Pravin
authors: P
authors: Salunke
authors: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Ravi
authors: R
authors: Garg
keywords: Aneurysm; Glioblastoma; Intratumoral hemorrhage