Although rare, neoplasms can be obstructed by intracerebral hemorrhage, delaying
histological diagnosis and proper treatment. We report the case of a 30-year-old male
presenting with serial intracerebral hemorrhages in the left thalamus. Stereotactic biopsy
failed to make histologic diagnosis; open biopsy, two months after the initial hemorrhage,
diagnosed glioblastoma. The characteristics of hemorrhage from glioblastoma drawn from
our experience and a comprehensive review of the literature include the following: (1) under
14 years of age or old age (2) deep seated supratentorial or posterior fossa location (3)
disproportionately diffuse brain edema (4) suspiciously enhancing mass lesion (5) irregular
shape and heterogeneous appearance with solid areas of blood, multiple hemorrhage, and
a ring-shaped hemorrhage. Direct proof of hemorrhagic origin is necessary for diagnosis
and treatment of intracerebral hemorrhage with atypical location, imaging findings, or clinical
course.