Two cases of extensive spontaneous hemorrhage related to intracranial angioblastic meningiomas are reported. One of these also had glandular and papillary formations with mucin production. A review of 115 meningiomas with significant hemorrhage including the two current instances disclosed that they occurred in the first to ninth decades of life but were most common in the fourth to eighth decades (85%), with a peak occurrence in the fifth decade (24%). The average age of 51 years was 9 years more than in those patients with non‐bleeding meningiomas. The female‐ to‐male ratio was 6:5 for the entire series. Bleeding meningiomas arose most often on the cerebral convexity followed by the parasagittal region, the lateral ventricle, and the sphenoid ridge. Bleeding most frequently involved multiple sites, and was followed in decreasing frequency by hemorrhage into the subarachnoid space, subdural space, intracerebral tissue including the peritumoral region, and intratumoral substance. Meningocytic menin‐gioma was the most common type of bleeding meningioma, followed in decreasing frequency by the angioblastic, fibroblastic, transitional and malignant types. The mech‐anism of bleeding was uncertain in many cases, and multiple factors are probably involved. Patients with bleeding meningiomas had worse prognoses than those with non‐bleeding meningiomas.
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