Six children with subarachnoid hemorrhage as the initial symptom of brain tumor are reported from the Depts of Neurosurgery, Univ. of Occupational and Environmental Health, Kitakyushu, and Kumamoto Univ Med Sch, Kumamoto. They represented a 3.6% of 167 new pediatric cases of brain tumor seen in 7-17 years at 2 centers in Japan. Two neonates presented with irritability, vomiting, cyanotic spells, and unilateral facial paresis. Four children, ages 4 to 15 years, developed sudden headache and vomiting with or without alteration of consciousness. The tumor locations were posterior fossa (2 medulloblastomas, one ependymoma, one hemangioma) and hypothalamus (one astrocytoma and one unverified). All were located close to the III or IV ventricles. The ultimate prognosis was poor. [1]

COMMENT: Medulloblastoma is more apt to bleed than other neuroectodermal tumors in pediatric patients. Compared to brain tumors in adults, those in children bleed more frequently and are more commonly located in the posterior fossa. Brain tumor should be considered as a possible etiology of subarachnoid hemorrhage in the neonate and child.