Kondziolka D, Bernstein M, Resch L, Tator C H, Fleming J F, Vanderlinden R G, Schutz H
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada.
J Neurosurg. 1987 Dec;67(6):852-7. doi: 10.3171/jns.1987.67.6.0852.
A retrospective clinical and pathological review of 905 consecutive brain tumor cases (excluding pituitary adenoma and recurrent tumor) was conducted to identify cases in which intratumoral hemorrhage was confirmed grossly and/or pathologically. There were 132 cases so identified, for an overall tumor hemorrhage rate of 14.6%; of these, 5.4% were classified as macroscopic and 9.2% as microscopic. The presence of hemorrhage was correlated with the neurological presentation. The highest hemorrhage rate (70.0%) was found in patients with prior neurological history who experienced apoplectic deterioration (acute-on-chronic presentation). Only 57.1% of patients with acute deterioration in the absence of prior neurological symptoms had hemorrhages. The highest hemorrhage rate for primary brain tumors was 29.2% for mixed oligodendroglioma/astrocytoma, while the highest hemorrhage rate for any tumor type was 50% for metastatic melanoma. The clinical relevance of tumor hemorrhage is discussed.
对905例连续的脑肿瘤病例（不包括垂体腺瘤和复发性肿瘤）进行了回顾性临床和病理检查，以确定肿瘤内出血在大体和/或病理上得到证实的病例。共确定了132例，肿瘤出血总发生率为14.6%；其中，5.4%为肉眼可见出血，9.2%为显微镜下出血。出血的存在与神经学表现相关。在有既往神经病史且出现卒中样恶化（急性起病于慢性病程）的患者中，出血率最高（70.0%）。在没有既往神经症状而急性恶化的患者中，只有57.1%发生了出血。原发性脑肿瘤出血率最高的是混合性少突胶质细胞瘤/星形细胞瘤，为29.2%，而任何肿瘤类型中出血率最高的是转移性黑色素瘤，为50%。本文讨论了肿瘤出血的临床意义。
