Related Experiment Video
Updated: Aug 28, 2025
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Diffuse low-grade glioma misdiagnosed as acute cerebral infarction: A case report
Yipo Ma1, Jinfeng Zhang2, Ying Wen2
1Department of Radiology, Taicang City Hospital of Traditional Chinese Medicine, Taicang, Jiangsu, China.
Rationale:
Diffuse low-grade gliomas (DLGGs) are relatively rare tumors that are more likely to be misdiagnosed and wrongly treated in clinical practice. We report a case of DLGG detected by computed tomography and magnetic resonance imaging (MRI).
Patient Concerns:
A 58-year-old man suddenly phantom smells for half an hour and was previously healthy.
Diagnoses:
Computed tomography findings showed a leaf-shaped slightly hypodense shadow in the right temporal lobe with no obvious mass effect and an unclear boundary. MRI findings showed diffuse and slightly longer T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI)signal in the right temporal lobe and hippocampus, slight hyperintensity on diffusion-weighted imaging, diffuse swelling in the right temporal lobe and hippocampus, and shallower cerebral sulci and fissures. No obvious abnormal enhancement was observed on enhanced MRI. Contrast-enhanced magnetic resonance angiography showed no obvious abnormality.
Interventions:
Intravenous thrombolysis with alteplase (rtPA) was given first.
Outcomes:
The patient had an acute and persistent generalized tonic-clonic seizure and was given antiepileptic treatment. Immunopathological and molecular genetic testing diagnosed as DLGGs. After targeted chemotherapy, the patient's symptoms improved significantly.
Lessons:
For those cases with clinical acute neurological impairment and imaging findings similar to those of ischemic stroke, where the distribution of lesions is inconsistent with the distribution of blood vessels, and the time of onset does not match the imaging findings, the possibility of DLGGs should be considered.
Insights
Diffuse low-grade gliomas (DLGGs) can mimic stroke on imaging. Early consideration of DLGGs in patients with neurological symptoms and atypical imaging findings is crucial for accurate diagnosis and treatment.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Diffuse low-grade gliomas (DLGGs) are rare tumors often misdiagnosed.
- Accurate diagnosis is critical due to potential for incorrect treatment.
- This case highlights diagnostic challenges in DLGGs.
