Glioblastoma With Unusual Features: Presentation With Intracerebral Hematoma, Diagnosis With CT Perfusion and Subsequent Cerebral Venous Sinus Thrombosis With Resultant New Hemorrhage

Background: During the course of primary malignant brain tumors, there is an increased tendency for both intracerebral hemorrhage and venous sinus thrombosis. Case Report: A 63-year-old man presented with a headache, and a brain computed tomography (CT) scan showed a hematoma in the right occipital lobe. Magnetic resonance imaging (MRI) revealed almost complete rim enhancement, and CT perfusion showed increased cerebral blood volume values. A new bleeding focus and a thrombus extending from the superior sagittal sinus to the cortical vein were seen on CT and MRI scans performed due to the headache that developed the day before surgery. After surgical evacuation of the hematoma, a giant cell glioblastoma diagnosis was made as a result of pathological examination of the lesion. Conclusion: In challenging cases like this, perfusion techniques are useful. Cerebral venous sinus thrombosis should also be kept in mind during the perioperative and postoperative periods to avoid complications. Keywords: Glioblastoma, sinus thrombosis, perfusion imaging, cerebral hemorrhage, hematoma