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Intracranial hemorrhage caused by metastatic tumors

Department of Pathology, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Fifteen cases of metastatic brain tumors associated with massive subarachnoid, intracerebral, or intraventricular hemorrhage or a combination thereof are reported. Four patients had multiple bleeding cerebral metastasis. In 10 patients, stroke was the first manifestation of the neoplastic disease. It is concluded that metastases of choriocarcinoma, melanoma, and bronchogenic carcinoma are most prone to massive bleeding. The average survival from the beginning of neurologic symptoms was 65 days, but in seven patients, it was 11 days or less. Surgery seems to be beneficial in selected patients. Massive hemorrhage was a complication in 14 percent of our patients with metastases to brain versus 0.8 percent of those with gliomas.

Reprint requests should be addressed to Dr. Mandybur, Department of Pathology, University of Cincinnati Medical College, 231 Bethesda Avenue, Cincinnati, OH 45267.

Received for publication July 16, 1976.

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