Cases Simulating Cerebrovascular Accident

ABSTRACT

Although there are differences in the mode of onset, symptomatology and clinical course in the various types of cerebrovascular lesions, the general picture may be quite similar and it is often difficult to determine the nature of the lesion in any individual case from the clinical data. In the vast majority of cases the symptoms of a cerebrovascular accident are of sudden onset and reach maximum intensity within few minutes or a few hours at the most. Locksley, et al. have reported autopsies on people who died from spontaneous intracerebral or subarachnoid hemorrhage, and they found that a primary or metastatic brain tumor was the cause of hemorrhage in only 2%~3% of their necropsy. We presented our experience with two such patient whose clinical pictures before the surgery were quite similar with those of cerebrovascular accident. Cases with a large chronic subdural hematoma and cerebral glioblastoma multiforme demonstrated a sudden and dramatic onset of coma and focal neurological symptoms immediately before admission to the hospital. The responsible mechanism or etiology for the mode of such sudden dramatic onset of symptoms may be derangement of intracranial pressure mechanism and sudden hemorrhage in the tumor.