Abstract:
Introduction: Hemorrhagic stroke and cerebral infiltrative
neoplastic hemorrhage are different clinical entities that require
differential diagnosis for the correct management of the
pathology and patient approach.
Purpose: To demonstrate that hemorrhage as a complication
of cerebral infiltrative neoplastic process can imitate a
hemorrhagic stroke, because of the existence of a similar clinical
and paraclinical signs.
Material and methods: CT scan and MRI scan of a 53-yearold man.
Results: A 53-year-old man, normotensive, who suffered a
hemorrhagic stroke in the right temporal lobe and basal ganglia,
who was treated with partial recovery of motor and sensory
deficit. He was later hospitalized in the Neurology Department due
to his aggravation of the clinical condition. He was investigated by
brain MRI with visualization of a multifocal-polymorphic infiltrative
neoplastic process with mixed component: tissue, necrotic and
hemorrhagic content, located temporal on the right, with
extension in the basal ganglia, imaging picture suggestive for
primary tumor process, possibly multiforme glioblastoma or
secondary metastatic process.
Conclusions: Noteworthy, 510% intracranial tumors cause
intracranial bleeding which can be the first sign of a brain tumor.
The intratumoral hemorrhage might be associated with both
primary and metastatic brain tumor. Bleeding usually occurs in the
course of highly malignant gliomas and affects 58% of patients
with glioblastoma multiforme (GBM). The most important role in
the etiopathogenesis are abnormalities of tumor vascularization.
Both the microvascular proliferation with hiperplasya of
endothelial cells following obliteration and the presence of
numerous thin-walled, poorly formed or dilated vessels may cause
hemorrhages. The newly formed vessels within the tumor mass
are characterized by numerous structural abnormalities leading to
their dysfunction.
