Glioblastoma multiforme presenting as cryptogenic intracerebral hemorrhage.

We report a case of glioblastoma multiforme that presented as a large, spontaneous intracerebral hemorrhage (ICH). A 52-year-old woman developed headaches associated with photophobia and nausea. Computed tomography scan revealed a large ICH in the right temporal lobe. Further imaging, including magnetic resonance imaging and catheter-based arteriography, did not demonstrate an underlying lesion. She had 2-month follow-up imaging that was consistent with resolution of her hematoma and, again, no evidence of an associated mass. Six months after the initial ICH, she presented with worsening headaches. Magnetic resonance imaging of her brain at that time clearly demonstrated a large enhancing mass in the area of prior hemorrhage. Following tumor resection, histological diagnosis indicated glioblastoma multiforme. This case highlights the benefit of neurosurgical follow-up for patients with cryptogenic ICH and maintaining a high index of suspicion for brain tumor.