Cerebellar pilocytic astrocytoma presenting with intratumor bleeding,subarachnoid hemorrhage,and subdural hematoma |
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Authors: | Chang Sub Lee Ji Soon Huh Ki-Bum Sim Youn Woo Kim |
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Institution: | (1) Department of Neurosurgery, Cheju National University Hospital, 154, Samdo2dong, Jeju City, Jeju, 690-716, South Korea;(2) Department of Pediatrics, Cheju National University Hospital, 154, Samdo2dong, Jeju City, Jeju, 690-716, South Korea |
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Abstract: | Introduction Massive intracranial hemorrhage is a very rare initial presentation of cerebellar pilocytic astrocytomas. There are no reports
in the medical literature on a cerebellar pilocytic astrocytoma presenting with intratumor bleeding (ITB), subarachnoid hemorrhage
(SAH), and subdural hematoma (SDH).
Case report A 15-month-old boy presented with lethargy and nausea to our hospital. Magnetic resonance imaging showed a mass with ITB at
the left cerebellar hemisphere in addition to SDH in the posterior fossa and SAH at the interpeduncular cistern. The patient
underwent emergency surgery. On incising the dura, we found SDH, the tumor was visible at the cerebellar cortex, and near
total removal followed. Microscopic examination of tissue sections revealed a pilocytic astrocytoma.
Discussion The authors’ case is the first report with a presentation including ITB, SAH, and SDH. The presumed mechanism of the SAH and
SDH was leaking of the ITB into subarachnoid and subdural spaces. |
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Keywords: | Pilocytic astrocytoma Intratumor bleeding Subarachnoid hemorrhage Subdural hematoma |
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