Intracranial hemorrhage as the initial presentation of disseminated intravascular coagulation in association with malignancy.

A 76-year-old man presented with a sudden disturbance of consciousness and right hemiplegia. An initial computed tomographic examination revealed multiple hematomas. The laboratory studies were highly suggestive of disseminated intravascular coagulation, although the underlying diseases were unknown at the time of admission. Despite various attempts at management, including replacement therapy, bleeding was not controlled and the patient died on day 5. An autopsy revealed the presence of prostate and rectal cancers. This case illustrates the fact that a fatal intracranial hemorrhage can be the first manifestation of disseminated intravascular coagulation in association with malignancy.