Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Glioblastoma Mimicking Herpes Simplex Encephalitis

  • Nam, Tai-Seung (Department of Neurology, Chonnam National University Hwasun Hospital) ;
  • Choi, Kang-Ho (Department of Neurology, Chonnam National University Hwasun Hospital) ;
  • Kim, Myeong-Kyu (Department of Neurology, Chonnam National University Medical School) ;
  • Cho, Ki-Hyun (Department of Neurology, Chonnam National University Medical School)
  • Received : 2010.10.26
  • Accepted : 2011.08.08
  • Published : 2011.08.28
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Abstract

We report a case of 70-year-old man with glioblastoma presenting as acute encephalitic illness. The patient exhibited sudden onset of cognitive impairment and headache for 2 days. Initial brain MRI showed left temporal lobe hyperintensity, and cerebrospinal fluid cytology revealed a mild pleocytosis. The patient had initially improved after medical treatment with a presumptive diagnosis of herpes simplex encephalitis (HSE). After 8 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increases in size and surrounding perilesional edema in the left temporal lesion on T2-weighted images and a new contrast-enhancing lesion on gadolinium-enhanced T1-weighted images. Stereotactic brain biopsy revealed a glioblastoma. The atypical encephalitic presentation of glioblastoma should be considered if definitive evidence for the diagnosis of HSE cannot be obtained.

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References

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