Glioblastoma multiforme presenting as stroke: an electrophysiological and clinicopathological case report

A 55-year-old man having hemiplegia after the sudden onset of a stroke was referred for rehabilitation. Cerebral angiography had demonstrated occlusion of the left middle cerebral artery and steroid therapy had been started. Attempted tapering of the steroid therapy on admission for rehabilitation resulted in the patient having severe headaches and confusion. Blink reflex evaluation, somatosensory cerebral evoked potential determinations and visual evoked responses were all consistent with a widespread process involving the parietal lobe of the patient's left cerebral hemisphere. Computerized axial tomography indicated an abnormality consistent with a space-occupying lesion. Craniotomy revealed the presence of a glioblastoma multiforme in the left cerebral hemisphere. Electrodiagnostic evaluation was entirely consistent with the operative finding of widespread involvement of the patient's left parietal lobe. Stroke patients whose conditions deteriorate over time must be serially evaluated in order to determine possible other causes of their symptoms.