Wounded Glioma Syndrome: A Case Report With Narrative Review

Wounded glioma syndrome (WGS) is a rare but potentially fatal postoperative complication. It usually presents with cerebral edema and/or hemorrhage, which can develop even in regions of the brain distant from the surgical field, a phenomenon known as distant WGS. A 72-year-old woman developed holocranial headache and progressive left hemiparesis. Brain magnetic resonance imaging (MRI) revealed an intra-axial lesion in the right hemisphere. She underwent right frontoparietal craniotomy with lobectomy and resection of the lesion. Her initial postoperative course was favorable. However, on the eighth day, she suffered acute neurological deterioration. Cranial computed tomography (CT) revealed severe cerebral edema and hemorrhagic foci in previously unoperated regions. The patient developed refractory intracranial hypertension that did not respond to intensive treatment (corticosteroids, deep sedation, and osmotherapy) and subsequently died. Histopathological analysis confirmed a diffuse grade 2 astrocytoma. WGS poses a significant diagnostic and therapeutic challenge due to its low incidence and currently poorly understood pathophysiological behavior. Its unpredictable clinical course underscores the need for more comprehensive documentation and the development of standardized preventive protocols to mitigate the lethality of this entity.