DiMaio S M, DiMaio V J, Kirkpatrick J B
Am J Forensic Med Pathol. 1980 Mar;1(1):29-45. doi: 10.1097/00000433-198003000-00007.
In 10,995 consecutive medicolegal autopsies, there were 19 deaths due to an unsuspected primary intracranial neoplasm. Nine (47.4%) of the tumors were in the astrocytoma-glioblastoma category. The remainder included four cases of oligodendroglioma and one case each of medulloblastoma, microglioma, meningioma, teratoma, colloid cyst and pituitary chromophobe adenoma. In six cases, death occurred following abrupt loss of consciousness, or else the patient was found dead. In five of these six cases, there were no known preceding symptoms. The remaining 13 patients exhibited the characteristic symptoms produced by intracranial neoplasms, including symptoms of increased intracranial pressure, epilepsy, and psychiatric manifestations. Only one patient presented with a focal neurologic deficit which resolved in 24 hours. A comparison of the duration and type of symptomatology exhibited by these patients with a hospital patient population in which death was caused by a previously diagnosed primary intracranial neoplasm and an autopsy was performed underscored 1) the shorter duration of acute symptomatology, 2) the nonlocalizing nature of the symptoms manifested, 3) the lack of progression or change in symptoms in those patients in whom epilepsy was the primary manifestation of their underlying disease, and 4) the lower incidence of focal neurologic deficits as the presenting symptoms in our series.
在10995例连续的法医尸检中，有19例死亡是由未被怀疑的原发性颅内肿瘤所致。其中9例（47.4%）肿瘤属于星形细胞瘤-胶质母细胞瘤类型。其余包括4例少突胶质细胞瘤，以及各1例髓母细胞瘤、小胶质细胞瘤、脑膜瘤、畸胎瘤、胶样囊肿和垂体嗜色细胞瘤。6例中，死亡发生在意识突然丧失之后，或者患者被发现已死亡。在这6例中的5例中，之前没有已知症状。其余13例患者表现出颅内肿瘤产生的典型症状，包括颅内压升高症状、癫痫和精神症状。只有1例患者出现局灶性神经功能缺损，在24小时内缓解。将这些患者所表现出的症状持续时间和类型与因先前诊断的原发性颅内肿瘤死亡并进行尸检的住院患者群体进行比较，突出显示了：1）急性症状持续时间较短；2）所表现症状的非定位性；3）以癫痫作为潜在疾病主要表现的患者中症状缺乏进展或变化；4）在我们的系列中作为首发症状的局灶性神经功能缺损发生率较低。
