这项观察性研究旨在提供由于潜在转移 (mICH) 或脑肿瘤 (tICH) 病变引起的急性脑出血 (ICH) 的详细临床和影像学特征/检查。我们进行了一项回顾性、单中心研究，评估患者初次 CT 成像表现为隐匿性 ICH，根据 H 原子分类，后续 MRI 成像分为 tICH 或 mICH。回顾了人口统计学、临床和放射学数据。我们纳入了 116 名患者（tICH：20/116，17.24％；mICH：96/116，82.76％）。引起ICH的最常见恶性肿瘤是肺癌（27.59%）、恶性黑色素瘤（18.10%）和胶质母细胞瘤（10.34%）。观察到的三种最常见的中风样症状是局灶性缺陷（62/116，53.45％）、头晕（42/116，36.21％）和认知障碍（27/116，23.28％）。 mICH 患病率最高出现在枕叶 (mICH: 28.13%, tICH: 0.00%; p = 0.004)，tICH 发生在胼胝体 (tICH: 10.00%, mICH: 0.00%; p = 0.029)。抗凝治疗仅在 mICH 患者中频繁出现（tICH：0.00%，mICH：5.21%；p = 0.586）。 tICH 患者中出血量（tICH：12682 mm3，mICH：5708 mm3，p = 0.020）和水肿量（tICH：49389 mm3，mICH：20972 mm3，p = 0.035）明显更大。超过一半的肿瘤性 ICH 患者表现出类似中风的症状。 mICH 中肺癌最常见，tICH 中胶质母细胞瘤最常见。虽然临床表现相似，但肿瘤位置和治疗的显着差异是明显的。© 2024。作者。

This observational study aims to provide a detailed clinical and imaging characterization/workup of acute intracerebral hemorrhage (ICH) due to either an underlying metastasis (mICH) or brain tumor (tICH) lesion.We conducted a retrospective, single-center study, evaluating patients presenting with occult ICH on initial CT imaging, classified as tICH or mICH on follow-up MRI imaging according to the H-Atomic classification. Demographic, clinical and radiological data were reviewed.We included 116 patients (tICH: 20/116, 17.24%; mICH: 96/116, 82.76%). The most common malignancies causing ICH were lung cancer (27.59%), malignant melanoma (18.10%) and glioblastoma (10.34%). The three most common stroke-like symptoms observed were focal deficit (62/116, 53.45%), dizziness (42/116, 36.21%) and cognitive impairment (27/116, 23.28%). Highest mICH prevalence was seen in the occipital lobe (mICH: 28.13%, tICH: 0.00%; p = 0.004) with tICH more in the corpus callosum (tICH: 10.00%, mICH: 0.00%; p = 0.029). Anticoagulation therapy was only frequent in mICH patients (tICH: 0.00%, mICH: 5.21%; p = 0.586). Hemorrhage (tICH: 12682 mm3, mICH: 5708 mm3, p = 0.020) and edema volumes (tICH: 49389 mm3, mICH: 20972 mm3, p = 0.035) were significantly larger within tICH patients.More than half of the patients with neoplastic ICH exhibited stroke-like symptoms. Lung cancer was most common in mICH, glioblastoma in tICH. While clinical presentations were similar, significant differences in tumor location and treatments were discernible.© 2024. The Author(s).