Symptomatic intracranial haemorrhage in acute nonlymphoblastic leukaemia: analysis of CT and autopsy findings

Abstract

We studied the CT and autopsy findings in patients with symptomatic intracranial haemorrhage (ICH) in acute nonlymphoblastic leukaemia (ANLL). From 1982 to 1994, 38 (20%) of 194 patients with ANLL were diagnosed as having ICH, by CT in 17 patients, by autopsy in 11 and by both examinations in 10. Intracerebral haemorrhage occurred in 30 patients. Twenty-four patients with subcortical haemorrhage were classified into three types: a single haematoma (7), clustered multifocal haematomas (11), and separated multifocal haematomas (6). Subarachnoid haemorrhage (SAH) occurred in 22 patients; 15 with subcortical haemorrhage, 1 with subdural haemorrhage (SDH) and 6 without any other ICH. SDH was also found in 4 patients with parenchymal haemorrhage or SAH or both. Concurrent, multiple haemorrhages consisting of various combinations of intracerebral haemorrhage, SAH and SDH are characteristic of ICH in ANLL. Multiple or confluent haematomas occur preferentially in subcortical brain.