A HISTORY of sudden onset of symptoms in cases of brain tumor is not uncommon. The usual explanation for the apoplectiform attack is that a vascular accident or gross hemorrhage occurred into the tumor. This theory, however, is not supported by clinicopathologic investigations.1 In 1933 Oldberg2 reviewed 832 consecutive cases of glioma of the brain. Gross hemorrhage was found in only 31, or 3.72 per cent, of the cases. In only 7 were there striking features of vascular accident, such as sudden onset or acute exacerbation of symptoms. It is evident, then, that in less than 1 per cent of cases of glioma of the brain is gross hemorrhage responsible for the abrupt onset of symptoms. Similar statistical data were obtained in other types of brain tumor. Although the incidence of hemorrhage into tumor is generally low, during the past year we have observed 4 such cases.
GROSS SW, BENDER MB. MASSIVE HEMORRHAGE IN BRAIN TUMORS. Arch NeurPsych. 1948;60(6):612–617. doi:10.1001/archneurpsyc.1948.02310060065007
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