Massive intratumoral hemorrhage of ependymoma of the fourth ventricle

Introduction: Ependymomas of the fourth ventricle usually show slowly progressive neurological deterioration and acute onset resulting from major intratumoral bleeding is very rare. Case report: A 16-month-old girl, previously in good health, showed gradual gait disturbance and appetite loss. She was transferred to our hospital because of a large enhanced tumor of the fourth ventricle with mild hydrocephalus. She suddenly lost consciousness on the next day. A computed tomography showed massive intratumoral hemorrhage and acute hydrocephalus. Emergency tumor removal was performed. Histopathological diagnosis was ependymoma. Discussion: We speculated the mechanism of intratumoral hemorrhage in posterior fossa ependymomas.