Functional neurological disorders (FND) represent the second most common reason for neurological consultations, with an estimated annual incidence of 4 to 12 cases per 100,000 people and an approximate prevalence of 50 per 100,000 inhabitants. Despite their frequency, diagnosis is often delayed by an average of seven years—a period during which patients undergo multiple tests, repeated hospitalizations, and inappropriate treatments that unnecessarily increase the burden on healthcare systems.
diagnóstico clínico
Hemorragia Intratumoral en Metástasis Cerebrales de Tumores Sólidos en Pacientes con Cáncer Sistémico: Experiencia del Hospital Carlos Andrade Marín. Intratumoral Hemorrhage In Brain Metastases From Solid Tumors In Patients With Systemic Cancer: Experience From The Carlos Andrade Marín Hospital
Background: Intracranial hemorrhage in cancer patients constitutes a neuro-oncological emergency. Its timely detection is essential for management and prognosis, as it may be due to coagulopathy, drug treatment, or intratumoral hemorrhage.
Objectives: To identify tumors that cause brain metastases with intratumoral hemorrhage and determine their prevalence. To describe the clinical presentation, location, time of onset, prognosis, associated factors, and characteristic neuroimaging findings.
Methods: Descriptive observational study. Patients with intratumoral hemorrhage secondary to brain metastasis admitted to the Department of Neurology at Carlos Andrade Marín Hospital between February 2020 and January 2021 with a diagnosis of spontaneous intracerebral hemorrhage were included. Two patients were analyzed, as they met the inclusion criteria.
Results: The prevalence of intratumoral hemorrhage was 2.9%. The associated cancers were papillary thyroid carcinoma and metastatic immature teratoma. In both cases, the hemorrhage occurred approximately 10 months after the oncological diagnosis and presented with progressive focal neurological deficit, headache, and epileptic seizures. The diagnosis was established by neuroimaging and confirmed by histopathology.
Conclusion: Intratumoral hemorrhage in metastatic brain disease is rare, but its recognition is essential. Presentation with progressive focal symptoms, a history of active cancer, and atypical lobar hemorrhages should raise high suspicion.
