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Diagnosis

A patient may present common symptoms that  include seizure, nausea and vomiting, headache, and hemiparesis, the single most prevalent symptom is a progressive memory, personality, or neurological deficit due to temporal and frontal lobe involvement. The kind of symptoms produced depends highly on the location of the tumor, more so than on its pathological properties. The tumor can start producing symptoms quickly, but occasionally is an asymptomatic condition until it reaches an enormous size.

A careful neurological examination and additional tests are usually performed :

MRI - CAT -

Definitive diagnosis of a suspected GBM on CT or MRI requires a stereotactic biopsy or a craniotomy with tumor resection. Because the tumor grade is based upon the most malignant portion of the tumor, biopsy or subtotal tumor resection can result in undergrading of the lesion.

 

 

 

 

  

   

 

MRI:

 
The imaging and pathologic hallmark of GBM is necrosis. Hemorrhage can occur in up to 19%. On T2-weighted images appears to be a heterogeneous mass with high signal intensity. GBM is often associated with pronounced mass effect and vasogenic edema that is produced by abnormal neoplastic vessels that lack the normal blood–brain barrier, resulting in transudation of fluids and proteins into the extracellular space. The vasogenic edema surrounds the tumor and extends along the adjacent white matter tracts and usually produces significant mass effect. Heterogeneous enhancement with centrally nonenhancing regions is consistent with necrosis (Mechtler, 2009)

 

Gliobastoma (astrocytoma) WHO grade IV - MRI coronal view, post contrast. 15 year old boy. (Click on the image to enlarge)

 

 

Source:  Christaras A

Gliobastoma (astrocytoma) WHO grade IV - MRI sagittal view, post contrast. 15 year old boy. (Click on the image to enlarge)

 

  Source:  Christaras A
 

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Histopathological image of cerebral glioblastoma. Hematoxylin & esoin stain

(Click on the image to enlarge)

Source:  Wikipedia

 

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