gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Case report: 3 recent cases of glioblastoma revealed by intracerebral haemorrhage

Meeting Abstract

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  • corresponding author J.-R. Alliez - Service de Neurochirurgie, CHU NORD, Marseille, France
  • A. Bejenaru - Service de Neurochirurgie, CHU NORD, Marseille, France
  • L. Eva - Service de Neurochirurgie, CHU NORD, Marseille, France

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP190

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0458.shtml

Published: May 4, 2005

© 2005 Alliez et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

Glioblastoma revealed by spontaneous intracerebral haemorrhage is rare (4%). We report 3 recent clinical cases of glioblastoma revealed during surgery for intracerebral haematoma.We would particularly like to stress the need for rapid diagnosis.

Methods

Our 3 recent cases were all males aged 39, 47 and 69. Onset was acute with cephalea, vomiting, confusion and appearance within a few minutes of the neurological disorders. Diagnosis was made following CT scan which showed a voluminous intracerebral hematoma followed by emergency surgery. Following surgery and histological results, treatment consisted of chemotherapy, radiotherapy and CT/MRI monitoring.

Results

These 3 cases each presented a malignant tumour revealed by intracerebral haemorrhage. Histological examination of the clots confirmed the diagnosis of glioblastoma. At the time of the initial examination, 2 of the patients presented coma (GCS: 7-8) with neurological deficit. The third presented a GCS of 12 and intracranial hypertension. The initial CT scan revealed an intracerebral hematoma in all 3 cases (1 case left temporal hematoma, 2 cases right temporo-parietal hematoma) with significant mass effect. The initial diagnosis was spontaneous intracerebral haemorrhage with increased HTA in 1 case. All 3 patients were submitted to emergency surgical treatment. In 2 cases, macroscopic gross-total excision was possible. One case was operated for spontaneous intracerebral haematoma and 15 days later for malignant tumour after a second haemorragic accident. The post-operative volution was favourable in the first weeks: 1 case recovered motivity entirely and 1 case had minimum side effects. The third patient presented hemiplegy after the second procedure. There was tumour recurrence after 13 weeks in 1 patient who refused all complementary treatment and after 17 weeks in another patient who was treated by radio and chemotherapy. The last case is currently undergoing a course of chemotherapy 6 months after surgery. Two patients died, the first 9 months after the initial haemorrhage and the other after 21 months.

Conclusions

Glioblastoma revealed by intracerebral haemorrhage is rare. It is difficult to preoperatively detect a tumoral lesion in an emergency situation. In patients presenting intracerebral haemorrhage, it is important to perform a histological exam of the tissue surrounding the clot and to withdraw the clot in order detect a possible glioblastoma in the form of a cerebral haemorrhage.