Intracranial hemorrhages in brain tumors

Intracranial hemorrhages in brain tumors
Intracerebral haemorrhage occurring in brain tumors occur in almost all cases of malignant tumors. Although intracerebral hemorrhage may occur in a wide variety of brain tumors, however, is most frequently detected in glioma, metastasis, adenoma and meningioma. Hemorrhage occurs frequently in these types of gliomas - in order of frequency - astrocytomas, glioblastoma multiforme, the oligodendroglioame and mixed astrocytoma-oligodendrogliom version.
With low malignant astrocytoma is rarely associated with intratumoral hemorrhage. Histological aspects are hipervascularizatia bleeding may indicate potential or proliferating endothelial focal necrosis. Bleeding may be precipitated by head trauma. It is believed that the bleeding is very rare in astrocytoma.
Astrocytoma or glioblastoma multiforme is the most common malig established an intratumoral hemorrhage. The tumor usually occurs before symptomatic bleeding, although sometimes it is the first manifestation of malignancy. Bleeding usually occurs in a single outbreak. They described cases of cerebral hemorrhage in the multicentric malignant astrocytoma. Hemorrhage and necrosis is produced by the tumor or vascular rupture glomeruloide or by parenchymal infiltration of tumor rupture. Oligodendrogliomul has a tendency to bleed more than astrocytoma and glioblastoma multiforme. Hemorrhage also occurs through abnormal rupture.
Mixed gliomas, one astrocytoma and oligodendrogliom combination, are a rare variant of glioma that have a high tendency to intratumoral hemorrhage. Bleeding in brain metastases - the incidence of bleeding in brain metastases is 14%. Among the most frequent metastases are associated with bleeding starting point of melanoma coriocacinom tumors of the lung and renal cell carcinoma. Bleeding in brain metastases of malignant melanoma occur in approximately 30% of cases. Although metastases are usually multiple, multiple simultaneous outbreaks are rare bleeding. The location of these metastases is predominantly cortico-subcortical. Much of the visible metastases at CT as non-bleeding, pathological examination proved to be intratumoral hemorrhage.
Metastases occur with a frequency of coriocarcinom estimated at 20% and is considered to be more common in Asian population. Bleeding in these metastases are large islands containing coriocarcinom clot and malignant cells in blood vessel walls. The mechanisms of bleeding are likely multiple brain metastases. The most common precipitating factor in malignant tumors, bleeding is considered abnormal intra and peritumoral vascular vessels. Sometimes in the advanced stages of infiltrative tumors, bleeding may appear as a ring surrounding the tumor and adjacent parenchyma separates. If either occurs coriocarcinomului vascular invasion by tumor by local metastasis or tumor emboli cause vascular occlusion, necrosis, pseudoanevrisme forms, with the possibility of vascular rupture.
Head injuries are a certain risk factor to trigger bleeding.
Concomitant anticoagulant therapy for deep cerebral thrombosis seems to not increase the risk of bleeding into the tumor, although they were reported and such cases.
Coagulabilitate disorders may predispose to intratumoral hemorrhage, reported cases were treated with intravenous heparin or oral anticoagulation to prevent systemic or pulmonary embolism or cerebral ischemia.