Meningioma manifesting intracerebral haemorrhage: A possible mechanism of haemorrhage

We present a possible mechanism of intracerebral peritumoural haemorrhage i n meningioma based on the clinical data of three of our cases. A meningioma manifesting intracerebral haemorrhage is uncommon and some sporadic case r eports have been presented, but without any proven mechanisms. We are presenting three cases of convexity meningioma manifesting spontaneo us intracerebral haemorrhage with apoplectiform onset. All three patients h ad no evidence of bleeding tendency or other predisposing Factors for haemo rrhage. Preoperative radiological studies showed a solid mass attached to t he dura with intracerebral peritumoural haematoma. Total removal of the tum our and haematoma could be achieved in every case. Histological investigati on revealed extensive tumour infarction in two cases and fibrosis related t o pre-existing ischaemia in the other case. The diagnoses were atypical men ingioma in two cases and transitional type in one case. We suggest that extensive tumour infarction might be a cause of spontaneous intracerebral peritumoural haemorrhage in our series of patients.