Concluded Case

A case of GLIOBLASTOMA MULTIFORME

New case 59 yr,M, No known comorbidities,presented with two episodes of unprovoked rt upper limb clonic movements, 1st episode 2 months ago,2nd episode16th of this month. Each episode lasted for one mt only.2nd episode while taking the bed coffee and the cup fly off from the hand.Following the 2nd episode , the wife noted some difficulty to communicate which lasted for an hr only.Denied having any head ache or motor weakness. On exam BP 130/ 90 mmhg ,normal optic fundi .No long tract signs. MRI brain with MR spectroscopy done. MR spectroscopy shows elevated choline peak and increased choline creatinine ratio in the enhancing area of lesion and immediate surrounding white matter.Elevated lactate peak seen inthe central necrotic part of the lesion. After the MRI ,patient was ref to Neurosurgeon and the surgery is going on today. What abnormality in the MRI and what is the possible diagnosis?

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Concluded answer
Thanks Curofy curofy and all Doctors who answered. Discussion :what abnormality in the MRI with possible disgnosis Surgery done : Biopsy-- GLIOBLASTOMA MULTIFORME. MRI: I'll defined left parenchymal mass lesion, showing heterogeneous contrast enhancement, central necrotic areas and I'll defind foci of internal hemorrhage. Altered signal in the left centrum semiovale , left superior parasagittal frontal cortex, right frontal periventricular white matter
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Glioma, Craniotomy and tumour decompression
Thank you doctor
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Thanks Curofy curofy and all Doctors who answered. Discussion :what abnormality in the MRI with possible disgnosis Surgery done : Biopsy-- GLIOBLASTOMA MULTIFORME. MRI: I'll defined left parenchymal mass lesion, showing heterogeneous contrast enhancement, central necrotic areas and I'll defind foci of internal hemorrhage. Altered signal in the left centrum semiovale , left superior parasagittal frontal cortex, right frontal periventricular white matter
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Thank you doctor
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But for the rt frontal and collosal oedema, i wud label this post lesion as GBM,. But with that one needs to rule out mets
I agree
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Such patients could present with acute hemiparesis also. How to differentiate vascular lesions with neoplasm
Glioma compressing surrounding structures Rx decompression by surgical removal
Thank you doctor
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IT MAY B CASE OF HIGH GRADE GLIOBLASTOMA
Valuable opinion
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