ISCHEMIC STROKE VERSUS GLIOBLASTOMA OCCURRENCE – A CASE REPORT AND REVIEW OF THE LITERATURE

Abstract

Background: Ischemic stroke and gliomas are pathologies with poor prognosis. Aside from different characteristics and incidences, 10% of ischemic stroke patients will develop glioblastoma in the post-ischemic period. The aim of this study is to present the interplay between cerebral ischemic stroke and glioblastoma in one patient and to review literature data. Case Description: A 61-year-old patient got sick and became confused and inadequate, incorrectly replacing words and syllables. He complained of a severe headache the whole day. The patient was transported to the Emergency Department of UMHAT "DrGeorgiStranski", and after a neurological examination and a native CT examination of the brain, the patient was admitted to the Neurology clinic with a diagnosis of MCA ischemic stroke. The neurological examination showed a central lesion of the right VIIth and XIIth cranial nerves, Babinski sign (+) on the right side, sensory loss of the right arm and sensory aphasia. Glasgow-Liege Scale (GLS) =18. National Institutes of Health Stroke Scale (NIHSS) = 6. After 4 days of active medical treatment, the patient was discharged from the clinic with improvement. In 2 months and 10 days, the patient was admitted to the ED again with worsening of the clinical signs. An MRI (with contrast) of the head diagnosed the patient with a brain tumor (glioma), and he was admitted to the Neurosurgery clinic for operative treatment. Conclusion: Ischemic stroke as an early manifestation of brain cancer is rare. Approximately 10% of patients with ischemic stroke may develop glioblastoma. Exact diagnosis and specific treatment of stroke or glioma is always challenging and requires appropriate MRI or CT protocols to make timely and accurate differentiation.