An Interesting Case of Gliosarcoma Presenting as Interhemispheric Bleed

A young male patient presented to our hospital with sudden onset severe headache and weakness in right hand. On neurological examination, patient was conscious but drowsy. He had right upper limb weakness, power 3/5 (on MRC scale), power in rest of the three limbs was intact. CT brain with contrast was suggestive of moderate size haematoma in left frontal parasagittal region (Figure 1, 2). Suspecting a vascular aetiology, patient was investigated with MR angio & DSA, which was not conclusive (Figure 3, 4). As patient’s consciousness was deteriorating, he underwent emergency craniotomy, intra-operatively, there was large haematoma overlying a solid reddish black coloured tumour in left frontal parasagittal area. Tumour was excised completely with haematoma (Figure 5). Post operatively patient’s condition improved well but there was minimal improvement in power in right upper limb at discharge. Histopathological report was suggestive of Gliosarcoma. Patient was planned for chemo-radiotherapy after 15 days.