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Journal of Korean Neurosurgical Society 2011;50(2): 119-122.
doi: https://doi.org/10.3340/jkns.2011.50.2.119
Glioblastoma Mimicking Herpes Simplex Encephalitis.
Tai Seung Nam, Kang Ho Choi, Myeong Kyu Kim, Ki Hyun Cho
1Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea. nts0022@hanmail.net
2Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
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.
Key Words: Glioblastoma; Herpes simplex encephalitis
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