Subependymoma presenting as subarachnoid hemorrhage

Changaris, David G.; Powers, James M.; Perot, Phanor L.; Hungerford, G D; Neal, George B.

doi:10.3171/jns.1981.55.4.0643

Cited by 35 publications

(14 citation statements)

References 26 publications

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“…It is surprising the fact that during the surgical procedure, most authors describe the subependymoma displaying radiological signs of intratumoral bleeding as an avascular mass, being the hemorrhage only demonstrated in the microscopic study. Most of these pathological descriptions include the presence of dilated capillaries, areas of recent microhemorrhages and/ or the presence of hemosiderin-ladden macrophages, indicating old hemorrhage 2,17 . Only in two cases the presence of large areas of massive intratumoral hemorrhage has been reported 7,13 .…”

Section: ; 21mentioning

confidence: 99%

“…Nevertheless, two cases of subependymomas presenting intratumoral areas of old hemorrhage, who only complained of long-term headache without signs of hydrocephalus, have been described 5,17 . In contrast, the presence of extratumoral hemorrhage can produce a clinical picture indistinguishable from that of a subarachnoid hemorrhage 2,4,9,14 . In this context a lumbar puncture may be performed without excluding the presence of a supratentorial mass, with the evident risk of brain herniation.…”

Section: ; 21mentioning

confidence: 99%

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Spontaneous acute hemorrhage within a subependymoma of the lateral ventricle: successful emergent surgical removal through a frontal transcortical approach

Carrasco¹,

Pascual

Navas

et al. 2010

Neurocirugía

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SummaryIntroduction. Subependymomas are benign neoplasms intimately related to the ventricular system which only exceptionally associate hemorrhagic events. We present neuroradiological and pathological evidences of intratumoral hemorrhage within a single case of subependymoma operated on at our institution. Additionally we analyze retrospectively the well-defined reports of similar cases published in the scientific literature.Case report. ResumenIntroducción. Los subependimomas son neoplasias benignas que se desarrollan en estrecha relación con el sistema ventricular y que excepcionalmente asocian fenó-menos hemorrágicos. Describimos el caso de un subependimoma localizado en el ventrículo lateral que presentó una hemorragia intratumoral aguda de forma espontá-nea, como se evidenció en los estudios neurorradiológicos y patológicos realizados, incluyendo un análisis exhaustivo de los casos similares descritos en la literatura científica.Caso clínico. Se trata de un varón de 71 años que recibía tratamiento anticoagulante, y que presentó un cuadro brusco y progresivo de disminución del nivel de conciencia. Los estudios de neuroimagen evidenciaron la presencia de una masa localizada en el ventrículo lateral izquierdo, con signos de hemorragia reciente en su seno, que producía hidrocefalia biventricular aguda. La lesión fue resecada en su totalidad de forma urgente mediante un abordaje frontal transcortical. El estudio patológico de la lesión demostró que se trataba de un subependimoma con focos hemorrágicos. En el periodo postoperatorio, el paciente presentó un déficit de memoria global, tanto anterógrada como retrógrada.Conclusiones. Los episodios de hemorragia espontánea aguda constituyen un fenómeno excepcional en el caso de los tumores de histología benigna como los subependimomas, y pueden transformar un curso clínico asintomático en una emergencia quirúrgica debido al desarrollo de hidrocefalia aguda. La extirpación completa de la lesión de forma urgente representa la opción de manejo quirúrgico más apropiada, ya que permite un reestablecimiento inmediato de la circulación de líquido cefalorraquídeo y previene la aparición de resangrado.PALABRAS CLAVE: Prosencéfalo basal. Región septal. Subependimoma. Tumor cerebral hemorrágico. Ventrículo lateral.

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Section: ; 21mentioning

confidence: 99%

Section: ; 21mentioning

confidence: 99%

Spontaneous acute hemorrhage within a subependymoma of the lateral ventricle: successful emergent surgical removal through a frontal transcortical approach

Carrasco¹,

Pascual

Navas

et al. 2010

Neurocirugía

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“…13,20,24,29,30) Overall, the neuroimaging characteristics of subependymomas are nonspecific, which makes preoperative diagnosis difficult. 4) Seven cases of subependymoma presenting as IVH or subarachnoid hemorrhage have been reported (Table 1), 1,3,12,16,23,24) in which the patient age ranged from 16 to 81 years, and the tumor arose in the lateral ventricle or septum pellucidum. These tumors were sometimes quite large, with the greatest dimensions of 5 cm 12) and 7 cm 1) in length.…”

Section: Discussionmentioning

confidence: 99%

Subependymoma in the Lateral Ventricle Manifesting as Intraventricular Hemorrhage -Case Report-

Akamatsu

Utsunomiya

Suzuki

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 32-year-old man presented with subependymoma in the lateral ventricle causing intraventricular hemorrhage and manifesting as severe headache and disturbance of consciousness. Computed tomography on admission showed a massive intraventricular hemorrhage and acute obstructive hydrocephalus. Cerebral angiography revealed no abnormal findings. Emergency external ventricular drainage was performed, and his neurological deficits gradually improved. Magnetic resonance imaging at 5 weeks after admission showed a tumor arising from the septum pellucidum or the floor of the right lateral ventricle, appearing as a mixed-intensity solid tumor, which was partially enhanced following gadolinium administration. The tumor had arisen from the septum pellucidum and was totally removed via an interhemispheric anterior transcallosal approach. Histological examination found typical subependymoma, with little vascularity. Intraventricular hemorrhage from cerebral neoplasms is usually due to highly vascular tumors. Since subependymomas are quite benign and show poor vascularity, intraventricular or subarachnoid hemorrhages are very rare, but do occasionally occur.

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“…Concerning brain metastases, malignant melanomas, lung cancer, hypernephroma, thyroid cancer, and chorion carcinoma are especially prone to intralesional hemorrhage [83] (Figure 8). With regard to primary intraaxial tumors, intratumoral hemorrhage is most commonly observed in malignant gliomas (glioblastomas, oligodendrogliomas; Figure 9), meningiomas, schwannomas, subependymomas, as well as in primitive neuroectodermal tumors [84][85][86][87]. Possible underlying pathomechanisms of intratumoral hemorrhages include rapid tumor necrosis, invasion of parenchymal blood vessels by the tumor, and rupture of newly formed blood vessels [83].…”

Section: Intracranial Neoplasmsmentioning

confidence: 99%

Differential Diagnosis of Nontraumatic Intracerebral Hemorrhage*

Linn

Brückmann

2009

Clin Neuroradiol

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A wide variety of nontraumatic pathologies can result in intracerebral hemorrhage (ICH). Primary causes such as arterial hypertension or cerebral amyloid angiopathy can be differentiated from secondary pathologies, such as neoplasms, arterio-venous malformations, coagulopathies, hemorrhagic ischemic strokes, and cerebral venous and sinus thrombosis.Here, the authors first provide some general information on epidemiology, clinical presentation, and imaging appearance of ICHs followed by a detailed discussion of the different underlying pathologic entities and their imaging presentation.

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Subependymoma presenting as subarachnoid hemorrhage

Abstract: ✓ Symptomatic subarachnoid hemorrhage (SAH) in a young patient originated in a non-obstructive lateral ventricular subependymoma. A brief review of brain tumors known to cause SAH is discussed. The computerized tomography scans are presented.

Cited by 35 publications

References 26 publications

Spontaneous acute hemorrhage within a subependymoma of the lateral ventricle: successful emergent surgical removal through a frontal transcortical approach

Spontaneous acute hemorrhage within a subependymoma of the lateral ventricle: successful emergent surgical removal through a frontal transcortical approach

Subependymoma in the Lateral Ventricle Manifesting as Intraventricular Hemorrhage -Case Report-

Differential Diagnosis of Nontraumatic Intracerebral Hemorrhage*

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