Subarachnoid and intracerebral hemorrhage from intracranial hemangiopericytoma: An uncommon cause of intracranial hemorrhage.

Abstract

Hemorrhage from an intracranial tumor is well known but uncommon. In cases of subarachnoid hemorrhage, aneurysm rupture is a main cause. A 64-year-old woman presented with sudden-onset motor aphasia. Computed tomography revealed subarachnoid hemorrhage, and intracerebral hemorrhage in the left temporal lobe. From the findings of pre-enhancement computed tomography, hemorrhage from a left middle cerebral artery aneurysm was initially suspected. Further radiological examinations demonstrated an enhanced mass with dural attachment in the left temporal region, but no vascular abnormality. Emergency craniotomy was performed, and the tumor and intracerebral hematoma were removed. The hemorrhage from fragile tumor vessels may destroy the tumor tissue and spread into the temporal lobe and subarachnoid space. Pathological examination of the tumor yielded findings consistent with hemangiopericytoma. Post-operatively, the patient was treated to prevent vasospasm. Although an intracranial tumor including hemangiopericytoma uncommonly causes subarachnoid hemorrhage, it should be taken into consideration as a source of intracranial hemorrhage.