Brain Tumors Can Cause Bleeding in the Brain

Brain tumors can cause strokes and bleeding in the brain. Sometimes, when there is an unexplained brain hemorrhage (bleeding in the brain) doctors search for a tumor as a possible cause. If you have had a brain tumor or if you have had bleeding in the brain, you might have some questions about the link between brain hemorrhage and brain tumors.

What Are Brain Tumors?

Brain tumors that can cause strokes and hemorrhages include primary brain tumors, as well as metastatic cancer that has spread to the brain.

A primary brain tumor is a tumor that started in the brain. These types of tumors include meningioma (generally benign and slow growing,) pituitary tumors, glioma (generally aggressive and fast growing,) and others.

Metastatic tumors are cancers that started in one area of the body (such as the lungs, breast or kidneys) and spread to another part of the body. Tumors that started elsewhere in the body may then spread to the brain.

What Are the Symptoms Of Hemorrhage Caused By a Brain Tumor?

Symptoms of a stroke that is caused by a brain tumor develop differently from typical stroke symptoms. This is because most strokes happen due to a sudden blockage of blood flow to a region of the brain, which causes stroke symptoms to develop suddenly.

By contrast, tumors are growths that enlarge relatively slowly into the brain tissue, causing symptoms that develop gradually, over days, weeks or months.

When a brain tumor causes bleeding, it typically produces symptoms that are similar to those of a typical hemorrhagic stroke.

The symptoms of bleeding from a brain tumor depend on several factors. Most importantly, the amount of blood that enters the brain tissue determines whether symptoms will be minor or substantial.

The symptoms of a bleeding brain tumor also depend on where the bleeding takes place, because bleeding in one region causes neurological symptoms that are different from those caused by bleeding in another region. Thus, signs of bleeding in the brain can range from a simple headache to life-threatening paralysis. The most common symptoms of a bleeding brain tumor include:

  • Weakness of the face and/or arm, and/or leg on one side of the body
  • Numbness in the face, and/or arm, and/or leg one side of the body
  • Inability to understand spoken language or inability to speak
  • Inability or difficulty writing or reading
  • Vertigo and/or gait imbalance with or without nausea or vomiting
  • Severe headache or double vision
  • Changes in vision or vision loss
  • Seizures or convulsions

How Is a Bleeding Brain Tumor Diagnosed?

Bleeding from a brain tumor is usually diagnosed with the aid of a Brain CT scan, which is one of the brain imaging tests used to evaluate a suspected problem in the brain. With a Brain CT scan, the area of bleeding typically appears as a bright white area in contrast to the grayish appearance of the normal brain tissue.

Bleeding in the brain is typically surrounded by a darker area, which represents an area of swelling.

Most injuries and damage to the brain, including strokes and brain tumors, cause swelling. The shape and size of this area of swelling helps doctors differentiate whether the bleeding is the result of a brain-tumor or the result of another condition, such as head trauma or a bleeding blood vessel.

Generally, if there is any suspicion that the bleeding is caused by a brain tumor, the next test is usually a Brain MRI, along with an injection of a contrast material known as gadolinium. This contrast material is used because it helps create a sharp contrast between areas of healthy brain, areas of blood, and areas of cancerous tissue.

How Likely is It For a Brain Tumor To Bleed?

Hemorrhagic strokes caused by bleeding from a brain tumor are relatively rare events, accounting for about 1-10% of all causes of intracerebral hemorrhage. More common causes of intracerebral hemorrhage include bleeding of an ischemic stroke, blood vessel rupture, amyloid angiopathy, and head trauma.

A brain tumor's tendency to bleed depends, in part, on whether the tumor it is benign, malignant, primary, or metastatic. Specific types of brain tumors have different characteristics, which make them more or less likely to bleed. For instance, up to 15% of all pituitary adenomas cause bleeding, while meningiomas rarely cause bleeding.

What Is the Treatment?

The treatment of bleeding in the brain caused by a brain tumor depends on the amount of blood and the symptoms it causes. The standard treatment is to remove both the blood and the tumor at the same time. However, sometimes, when the amount of blood is very small, and the patient’s symptoms are minor (e.g., headache), surgery may not take place right away.

Usually, if it is safe to wait for a few weeks, some tests can help determine whether there is cancer somewhere else in the body and whether or not other cancer treatments are needed, such as radiation and chemotherapy.

A Word From Verywell

A hemorrhage caused by a brain tumor can be one of the complications of cancer. Sometimes, a hemorrhage is the first sign of a brain tumor. If you or a loved one has had a brain hemorrhage caused by a tumor, you will need to follow up with a medical team, including an oncologist, a neurologist and a neurosurgeon. Recovery may be slow and exhausting. Strong support from family and friends can help make recovery easier.

Sources:

Tumoral Presentation of Homonymous Hemianopia and Prosopagnosia in Cerebral Amyloid Angiopathy-Related Inflammation, Hainline C, Rucker JC, Zagzag D, Golfinos JG, Lui YW, Liechty B, Warren FA, Balcer LJ, Galetta SL, J Neuroophthalmol. 2017 Mar;37(1):48-52

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