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Ischemic Stroke After Tumor Resection in a Patient With Glioblastoma Multiforme
Sara Soliman1, Medhat Ghaly2,1
1Internal Medicine, Yale-Waterbury Internal Medicine Residency Program, Waterbury, USA.
Cureus
|March 17, 2021
Summary
Glioblastoma multiforme (GM) is a rare brain tumor that can mimic stroke symptoms. This case highlights the diagnostic challenges and management of stroke occurring in a patient with GM.
Area of Science:
- Neuro-oncology
- Neurology
- Radiology
Background:
- Glioblastoma multiforme (GM) is the most common aggressive malignant glioma, comprising 15% of adult primary brain tumors.
- Ischemic strokes associated with gliomas are rare and present diagnostic challenges due to overlapping symptoms.
Observation:
- A 58-year-old male presented with worsening expressive aphasia and focal neurological deficits.
- Brain MRI revealed a large left frontal and temporal lobe mass, consistent with glioma.
- Post-surgical resection confirmed Glioblastoma multiforme (GM).
Findings:
- The patient experienced improved aphasia post-surgery but subsequently developed acute right-sided weakness and sensory deficit.
- Postoperative MRI confirmed an acute left posterior, frontal, and parietal infarct.
- Intravenous thrombolysis was contraindicated due to recent surgery.
Implications:
- This case underscores the complexity of diagnosing stroke in the presence of brain tumors.
- Management requires careful consideration of treatment contraindications, such as thrombolysis after surgery.
- The patient was discharged for outpatient radiation and temozolomide chemotherapy.
