The authors describe a case of congenital brain tumor associated with massive intracerebral hemorrhage. The patient, a 2, 230-g male, was born at full term after an uneventful pregnancy and delivery. Fourteen hours after delivery he developed dyspnea and a feeble, irritable cry. A computed tomographic scan obtained on the 2nd day of life disclosed a massive intracerebral hemorrhage and an irregular, enhanced area of high density in the right temporoparietal region. The tumor was removed and was histologically diagnosed as a benign astrocytoma.
A review of the literature revealed that congenital brain tumors often do not manifest in the perinatal period. Initial manifestations at birth are large head or hydrocephalus and, after birth, gradual onset of hydrocephalus or functional deterioration due to hemorrhagic stroke. Among the 33 reported cases, 16 (48%) were detected through tumor bleeding and 12 were found at autopsy. Glioma was the most common among congenital brain tumors with bleeding in the neonatal period. Radical surgery offers the best possibility of long-term survival for these patients.
