Hemorrhagic presentation of intracranial pilocytic astrocytomas: literature review

Prasad, Lakshmi G and Menon, Girish R (2019) Hemorrhagic presentation of intracranial pilocytic astrocytomas: literature review. Neurosurgical Review, 42. pp. 97-106. ISSN 0344-5607

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Pilocytic astrocytomas (PAs) are seemingly innocuous and benign tumors. However, in recent times, many case series have documented high rates of hemorrhage in these neoplasms. We hereby provide a detailed analysis on hemorrhagic pilocytic astrocytomas (HPA) in adults and report one such case managed at our institute. In addition, salient differences between adult and pediatric hemorrhagic PA have been briefed. Hospital records were retrieved for our case.Literature review was conducted by searching online databases for the following keywords—pilocytic astrocytoma,hemorrhage, cranial, pediatric, and adults. A 22-year-old male with neurofibromatosis-1 presented with sudden onset headache and vomiting of 3-day duration. Imaging revealed a lobulated suprasellar lesion with obstructive hydrocephalus. Pterional transsylvian approach and subtotal resection were performed. Histopathology showed features of PA with bleed. Including current report, a total of 26 cases have been reported. Mean age was 37 years (21–75 years) and they are mostly found in the third decade. The male:female ratio was 2.1:1. Sudden headache with vomiting was the most common symptoms. Tumors were mostly located in cerebral hemispheres (n = 9/34.6%), hypothalamus/ suprasellar region (n = 7/27%), and cerebellum (n = 6/ 23%). Two- hirds underwent gross total excision. There were two deaths and except one case, no recurrences were reported in those with available follow-ups. Hemorrhagic presentation of a PA is rare, although more commonly seen in adults and most commonly located in cerebral hemispheres.Maximal safe resection is the standard treatment and recurrences are rare.

Item Type: Article
Uncontrolled Keywords: Pilocytic astrocytoma; Hemorrhage; Hemorrhagic onset; Suprasellar; Chiasmatic hypothalamic; Cerebellum
Subjects: Medicine > KMC Manipal > Neuro Surgery
Depositing User: KMC Library
Date Deposited: 05 Mar 2019 04:09
Last Modified: 05 Mar 2019 04:09
URI: http://eprints.manipal.edu/id/eprint/153374

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