H3 K27-altered diffuse midline glioma presenting as massive cerebellopontine hemorrhage.
Childs Nerv Syst
; 39(8): 2229-2232, 2023 08.
Article
em En
| MEDLINE
| ID: mdl-36867241
ABSTRACT
We report the case of a 14-year-old boy who presented with extensive cerebellar and brainstem hemorrhage. Our presumptive diagnosis was a ruptured arteriovenous malformation (AVM), but two cerebral angiograms showed no significant vascular abnormalities. The patient underwent posterior fossa craniotomy and microsurgical evacuation of the hematoma. Pathological analysis of the hemorrhagic tissue made the diagnosis of diffuse midline glioma, H3 K27-altered (WHO grade 4), based on immunohistochemistry. He subsequently developed diffuse craniospinal leptomeningeal disease and progressed rapidly, with respiratory failure followed by severe neurologic decline without further hemorrhage. He was compassionately extubated at the request of the family and died before initiation of adjuvant therapy. This unusual case of a diffuse midline glioma presenting with massive hemorrhage underscores the importance of searching for an underlying etiology of hemorrhage in a child when a vascular lesion cannot be identified.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Glioma
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Adolescent
/
Child
/
Humans
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Male
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article