[01] Guru Dutta Satyarthee, Department of Neurosurgery, AIIMS, Gamma Knife and Trauma Centre, New Delhi, India. [02] Shikha S., Department of Neurosurgery, AIIMS, Gamma Knife and Trauma Centre, New Delhi, India.

Neurological worsening in case of supratentorial glioma within a week following biopsy procedure, can be caused by fresh onset hydrocephalus, worsening of pre-existing hydrocephalus, seizure, abscess, meningitis, acute enlargement of peritumoral edema or tumor bleed. Authors report a -40 year - female, who underwent ultrasound guided biopsy of right thalamic mass lesion, and histopathological report was glioblastoma multiforme and discharged on second day following biopsy. The immediate post-biopsy CT scan revealed presence of air pocket at site of biopsy, however, no hematoma was present. On seventh days following biopsy, she again presented to neurosurgical services with complaint of fresh onset neurological worsening, CT scan head revealed an unexpected intra-parenchymal subcortical delayed hemorrhage along the biopsy tract, inside the tumor at the site of biopsy. To the best of knowledge of authors, current case is the first report in the western literature, which developed delayed hematoma on seventh day following biopsy and underwent successful hematoma evacuation and subtotal decompression of thalamic glioma. Author recommends possibility of hematoma development during immediate follow-up period must be kept as one of differential diagnosis for neurological worsening, who underwent recent biopsy of intracerebral lesion. Possible mechanism, management and pertinent literature are reviewed.

Glioma, Delayed Hemorrhage, Biopsy Tract, Ultrasound Guided Biopsy, Intracerebral Lesion, Management

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