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Intratumoral hemorrhage (ITH) as a variant of intracranial hemorrhage (ICH) is a known, albeit rare, clinical entity. Hemorrhages within brain neoplasms seem to remain underreported, including angiomatous meningioma and pilocytic astrocytoma as well as sarcoma spread to CNS in pediatric cases. Neuropathological studies remain a valuable part of ITH assessment. New experimental therapies for brain tumors, including combinations with hyperbaric oxygen or treatment with kinase inhibitors need to be evaluated for their effect on brain tumor vascularization. A growing body of scientific evidence points towards the need to strengthen the significance of vascular component in brain tumor classification.