B-03 Neurocognitive Outcome from Anaplastic Astrocytoma: A Case Study of Neural Compensation

Abstract

Abstract Objective Anaplastic astrocytoma is a rare malignant brain tumor occurring in adults aged 30 to 50, with an incidence of 5 to 8 people per 100,000. Cognitive dysfunction is a complication after tumor resection, resulting from neurotrauma of surgery, chemotherapy, and radiation treatment. Neural compensation and neuroplasticity can allow intact cognitive functioning after brain resection in brain areas expected to be impacted by the neurotrauma. Method The current case study is a 45-year-old female post -resection for dendritic cell vaccine clinical trial followed by adjuvant radiation of an anaplastic astrocytoma of the frontal lobe. MRI of the brain post right frontal craniotomy was indicative of extra-axial fluid communicating with the anterior aspect of the right lateral ventricle, hemosiderin along the medial resection margin, and T2/FLAIR signal abnormality in the left medial and right inferior frontal lobes. Results Test data revealed intact global cognitive functioning (WAIS-IV; FSIQ = 101 SS), with below expected performance on verbal comprehension (WAIS-IV; VCI = 98 SS). Consistent with the area of resection, she had impairments in visuoconstruction and executive functioning specific to mental generativity. However, performances with regard to math achievement were intact (WIAT; Math Problem Solving = 110 SS; Numerical Operations = 104 SS), despite significant neurotrauma to the prefrontal cortex. She also produced left lateralized fine motor weakness. Conclusions Accommodations for work, outpatient therapies, and psychotherapy were recommended. This case enhances the understanding of neurocognitive performance after neurotrauma involving tumor resection and radiation treatment in rare malignant brain tumor, and highlights the impact of neural compensation after resection.