Kato Koichi, Moteki Yosuke, Nakagawa Masanori, Kadoyama Shigeru, Ujiie Hiroshi
Department of Neurosurgery, Tokyo Rosai Hospital, Tokyo, Japan.
Neurol Med Chir (Tokyo). 2011;51(1):82-4. doi: 10.2176/nmc.51.82.
A 20-year-old woman presented with subarachnoid hemorrhage (SAH) in the frontal interhemispheric fissure, and a cystic lesion in the left frontal lobe. Cerebral angiography demonstrated no aneurysm or vascular abnormalities. T(1)-weighted magnetic resonance imaging with contrast medium revealed an enhanced lesion along the falx. The lesion and cyst were removed, and histological examination revealed a pilocytic astrocytoma. Spontaneous intracranial hemorrhage from pilocytic astrocytoma is rare, with only 15 reported cases mostly involving intratumoral hemorrhage in the parenchyma of hypothalamic and cerebellar tumors. SAH caused by cerebral hemisphere pilocytic astrocytoma is extremely rare. This case suggests that interhemispheric fissure SAH, not associated with aneurysm or abnormal vascularity, could originate from small, low-grade glioma in the superficial cerebral hemisphere.
一名20岁女性因额叶大脑半球间裂蛛网膜下腔出血（SAH）以及左侧额叶囊性病变就诊。脑血管造影未显示动脉瘤或血管异常。增强T(1)加权磁共振成像显示沿大脑镰有强化病变。病变及囊肿被切除，组织学检查显示为毛细胞型星形细胞瘤。毛细胞型星形细胞瘤自发性颅内出血罕见，仅报道过15例，大多为下丘脑和小脑肿瘤实质内的瘤内出血。大脑半球毛细胞型星形细胞瘤导致的SAH极为罕见。该病例提示，与动脉瘤或血管异常无关的大脑半球间裂SAH可能起源于大脑浅表半球的小型、低级别胶质瘤。
