Review articleGlioblastoma presenting as spontaneous intracranial haemorrhage: Case report and review of the literature

- Glioblastoma may initially present as an intracerebral haemorrhage.
- Haemorrhagic presentation commonly delays diagnosis of glioblastoma.
- A malignant cause of spontaneous intracerebral haemorrhage is rare in young adults.
- All patients with unexplained intracranial haemorrhage may benefit from early MRI.

Glioblastoma (GB) classically presents with symptoms of raised intracranial pressure and gradual progressive neurological deficits. An acute presentation, with intracerebral haemorrhage (ICH) and rapid clinical deterioration, occurs infrequently. Contemporary imaging modalities do not reliably reflect underlying mass lesions in parenchymal brain haemorrhage at first presentation. We report a delayed diagnosis of GB in a 21-year-old patient presenting with spontaneous ICH and a negative initial neurovascular workup. A comprehensive literature review was performed to investigate the incidence of malignant aetiology for spontaneous ICH in young adults, and to underscore the importance of early utilisation of diagnostic magnetic resonance imaging (MRI) in such cases.