[Repeated intracerebral hemorrhage in malignant astrocytoma--a case of apoplectic manifestation (author's transl)].

A case of 26-year-old female with malignant astrocytoma was described. Intracerebral hemorrhage appeared in apoplectic fashion on two occasions and surgery was done after each attack. At the first operation, a hematoma in the right putaminal region was totally evacuated and a specimen from the cavity wall showed tumor cells which could not be classified histologically at that time. The patient fully recovered postoperatively. Astrocytoma was confirmed 4 months later by the second operation for the repeated intratumoral hemorrhage. Only a half of the tumor was removed by the third operation. It was apparent that the tumor occupied the site of the right basal ganglia and infiltrated the internal copsule. We discussed the massive intratumoral hemorrhage and propose a craniotomy instead of simple trepanation for the treatment of intracerebral hematoma in order to make adequate biopsy of the hematoma wall and to remove the coexisting tumor, if present.