Application of Computed Tomography for Differential Diagnosis of Glioma Stoke and Simple Cerebral Hemorrhage

  • Li, Xiao-Li (Department of Neurology, Renmin Hosipital, Hubei University of Medicine) ;
  • Zhou, Fa-Ming (Department of Neurology, Renmin Hosipital, Hubei University of Medicine) ;
  • Shangguan, Shou-Qin (Department of Neurology, Renmin Hosipital, Hubei University of Medicine) ;
  • Zou, Wen-Qin (Department of Neurology, Renmin Hosipital, Hubei University of Medicine) ;
  • Deng, Yan-Qing (Department of Neurology, Renmin Hosipital, Hubei University of Medicine) ;
  • Chen, Tao (Department of Neurology, Renmin Hosipital, Hubei University of Medicine) ;
  • Chen, Guang-Hui (Department of Neurology, Renmin Hosipital, Hubei University of Medicine)
  • Published : 2014.04.30


Objective: To explore the value of computed tomography (CT) in the differential diagnosis of glioma stroke and simple cerebral hemorrhage. Materials and Methods: A total of 45 patients with glioma stroke and stroke as the initial symptom in our hospital from Jun., 2009 to Oct., 2013 were selected along with 50 individuals with simple cerebral hemorrhage in the same period randomly collected as a control group. The CT results in both groups were analyzed and compared. Results: In the observation group, there were 25 patients with astrocytoma (55.6%), 11 with oligodendroglioma (24.4%), 8 with ependymoma (17.2%) and 1 with glioblastoma multiforma (GBM, 2.22%). Additionally, the major CT manifestation was coexistence of hemorrhage and tumor signs. By comparison, it could be found that the proportions of patients respectively with peripheral edema and space-occupying effect in the observation group were significantly higher than in the control group (P<0.01). Conclusions: Application of CT examination combined with medical history in patients has very important clinical value in the differential diagnosis of glioma stroke and simple cerebral hemorrhage.


  1. Barkovich AJ, Atlas SW (1988). Magnetic reasonance imaging of intracranial hemorrhage. Radiol Clin North Am, 26, 801-20.
  2. Beppu T, Sasaki M, Kudo K, et al (2011). Prediction of malignancy grading using computed tomography perfusion imaging in nonenhancing supratentorialgliomas. J Neurooncol, 103, 619-27.
  3. Berberat J, Grobholz R, Boxheimer L, et al (2014). Differentiation between calcification and hemorrhage in brain tumors using susceptibility-weighted imaging: a pilot study. AJR Am Roentgenol, 202, 847-50.
  4. Brott T, Broderic J, Barsan W, et al (1992). Hyper-acute clot retraction in spontaneous intracerebral hemorrhage. Stroke, 23, 141.
  5. Cervera V, Mai W, Vite CH, et al (2008). A case of glioblastoma misdiagnosed initially due to positive finding of antiglutamate receptor antibody. Rinsho Shinkeigaku, 48, 497-500.
  6. Choi G, Park DH, Kang SH, et al (2013). Glioma mimicking a hypertensive intracerebral hemorrhage. J Korean Neurosurg Soc, 54, 125-7.
  7. Das BR, Tangri R, Ahmad F, et al (2013). Molecular investigation of isocitrate dehydrogenase gene (IDH) mutations in gliomas: first report of IDH2 mutations in Indian patients. Asian Pac J Cancer Prev, 14, 7261-4.
  8. Doroudchi M, Pishe ZG, Malekzadeh M, et al (2013). Elevated serum IL-17A but not IL-6 in glioma versus meningioma and schwannoma. Asian Pac J Cancer Prev, 14, 5225-30.
  9. Fatterpekar GM, Galheigo D, Narayana A, et al (2012). Treatment-related change versus tumor recurrence in highgrade gliomas: a diagnostic conundrum--use of dynamic susceptibility contrast-enhanced (DSC) perfusion MRI. AJR Am J Roentgenol, 198, 19-26.
  10. Fiveash JB, Spencer SA (2003). Role of radiation therapy and radiosurgery in glioblastoma multiforme. Cancer J, 3, 222-9.
  11. Fraum TJ, Kreisl TN, Sul J, et al (2011). Ischemic stroke and intracranial hemorrhage in glioma patients on antiangiogenic therapy. J Neurooncol, 105, 281-9.
  12. Gielen I, Kromhout K, Gavin P (2013). Agreement between lowfield MRI and CT for the detection of suspected intracranial lesions in dogs and cats. J Am Vet Med Assoc, 243, 367-75.
  13. Iwamoto N, Murai Y, Yamamoto Y, et al (2013). Supratentorial extraventricular anaplastic ependymoma in an adult with repeated intratumoral hemorrhage. Brain Tumor Pathol, 31, 138-43.
  14. Jo JT, Schiff D, Perry JR (2014). Thrombosis in brain tumors. Semin Thromb Hemost, 40, 325-31
  15. Lee KR, Betz AL, Keep RF, et al (1995). Intracerebral infusion of thrombin as a cause of brain edema. J Neurosurg, 83, 1045-50.
  16. Narang J, Jain R, Scarpace L, et al (2011). Tumor vascular leakiness and blood volume estimates in oligodendrogliomas using perfusion CT: an analysis of perfusion parameters helping further characterize genetic subtypes as well as differentiate from astroglial tumors. J Neurooncol, 102, 287-93.
  17. Park SS, Chunta JL, Robertson JM, et al (2011). MicroPET/CT imaging of an orthotopic model of human glioblastoma multiforme and evaluation of pulsed low-dose irradiation. Int J Radiat Oncol Biol Phys, 80, 885-92.
  18. Pina S, Carneiro A, Rodrigues T, et al (2014). Acute ischemic stroke secondary to glioblastoma. A case report. Neuroradiol J, 27, 85-90.
  19. Ryken TC, Aygun N, Morris J, et al (2014). The role of imaging in the management of progressive glioblastoma: A systematic review and evidence-based clinical practice guideline. J Neurooncol, [Epub ahead of print].
  20. Skogen K, Ganeshan B, Good C, et al (2013). Measurements of heterogeneity in gliomas on computed tomography relationship to tumour grade. J Neurooncol, 111, 213-9.
  21. Wagner KR, Xi G, Hua Y, et al (1996). Lobar intracerebral hemorrhage model in pigs: rapid edema development in perihematomal white matter. Stroke, 27, 490-7.
  22. Wang L, Wu XY, Liu J, et al (2014). Evidence of Shenmai and cantharides injection for patients with breast cancer. Int J Med Res Clin Oncol, 1, 11-5.
  23. Wang YX, Fan K, Tao DB, et al (2013). Association between genetic polymorphism of xrcc1 gene and risk of glioma in ? Chinese population. Asian Pac J Cancer Prev, 14, 5957-60.
  24. Yilmaz U, Zeybek U, Kahraman OT, et al (2013). Investigation of ICAM-1 and $\beta3$ integrin gene variations in patients with brain tumors. Asian Pac J Cancer Prev, 14, 5929-34.
  25. Yu CY, Liang GB, Du P, et al (2013). Lgr4 promotes glioma cell proliferation through activation of Wnt signaling. Asian Pac J Cancer Prev, 14, 4907-11.

Cited by

  1. Diffuse leptomeningeal gliomatosis initially presenting with intraventricular hemorrhage: a case report and literature review vol.15, pp.1, 2015,