Brain Tumors May Cause Bleeding in the Brain

Although brain tumors can cause strokes, symptoms of stroke that is caused by a brain tumor symptoms 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 bleeds, it typically produces symptoms that are similar to those of a typical hemorrhagic stroke.

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 blood vessel rupture, amyloid angiopathy, and head trauma.

A brain tumor's tendency to bleed depends, in part, on whether 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 Are the Symptoms?

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 injury to the brain in one region causes neurological symptoms that are different from those caused by injury to the brain 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. Using 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 literally helps create a sharp contrast between areas of healthy brain, areas of blood, and areas of cancerous tissue.

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.

Read more about brain tumors.

Sources:

J. P. Mohr, Dennis W. Choi, James C. Grotta, Bryce Weir, Phillip A. Wolf Stroke: Pathophysiology, Diagnosis, and Management Churchill Livingstone; 4th edition (2004)

Inamasu , Y . Nakamura , R . Saito , Y . Kuroshima , K . Mayanagi , K . Ichikizaki Rebleeding from a primary brain tumor manifesting as intracerebral hemorrhage (CNN 04/077, revised version) . Clinical Neurology and Neurosurgery;108 (1);105 – 108.

Edited by Heidi Moawad MD

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