Spontaneous intracranial haematomas caused by neoplasms

We report about 50 patients with spontaneous intracerebral haematomas (ICH) caused by intracranial neoplasms to assess the underlying histological con dition, their presentation on admission, diagnostic work-up, treatment, his tological diagnosis, and clinical outcome. These patients were identified i n a prospective series of 2041 patients with intracranial neoplasms and 692 patients with spontaneous ICH, which were both consecutively collected ove r a nine-year-period. The frequency of ICH in patients with intracranial neoplasms was 2.4%. The frequency of tumour related ICH in the ICH group was 7.2%. The leading caus e of tumour related ICH were metastases of extracranial origin (n = 18; 36% ), followed by glioblastoma multiforme (n = 15; 30%). Nine patients (18%) h ad benign primary intracranial neoplasms. On admission 18 patients were som nolent (36%) and 14 patients (28%) were comatose. In 29 cases (58%) ICH was the first clinical sign of neoplastic disease, while in 21 patients (42%) a malignant tumour was already known. We operated on 45 patients (90%), fou r patients (8%) were not operated on because of poor clinical condition and died, one patient refused surgical treatment. Six patients (12%) died desp ite surgery. This series confirms the importance of a proper neuroradiological and clini cal work-up of patients with suspected tumour related ICH followed by opera tive treatment and histological confirmation of the diagnosis. This is supp orted by the fact that 18% of patients had prognostically favourable intrac ranial rumours which would not otherwise have been adequately treated.