Glioblastoma mimicking acute stroke: A case report and diagnostic challenges

Glioblastoma is the most common malignant primary brain tumor in adults. Gliomas infiltrate and destroy surrounding brain tissue, leading to neurological deficits such as speech and visual disturbances, hemiparesis, cranial nerve palsies, personality changes, and impaired consciousness. These symptoms may mimic acute stroke; however, 20-40% of patients initially diagnosed with stroke in the emergency department (ED) are later found not to have experienced an acute cerebrovascular event. Brain tumors account for approximately 5% of such stroke mimics. The aim of the study was to present a clinical case of brain tumor mimicking stroke. We present a 71-year-old woman admitted with suspected stroke due to impaired verbal communication, confusion, disorientation, and transient mild rightsided weakness. Symptoms had progressed over one week. Brain computed tomography revealed a hypodense lesion in the medial left temporal lobe, and magnetic resonance imaging suggested a high-grade glioma infiltrating deep structures. Intravenous dexamethasone was initiated. Navigated biopsy confirmed glioblastoma on histopathological examination. The patient was not eligible for oncological treatment and underwent supportive care, including rehabilitation. At discharge, she was ambulatory with caregiver assistance and remained on long-term dexamethasone with proton pump inhibitor (PPI) prophylaxis. Despite advances in therapy, glioblastoma carries a poor prognosis, with approximately 10% five-year survival.