Early Neurological Symptoms of Glioblastoma: The Importance of MRI for Timely Diagnosis of Persistent Headaches and Epileptic Seizures

Glioblastoma is one of the most aggressive and common brain tumors in adults, classified as a grade IV astrocytoma by the WHO. Early diagnosis is crucial for improving prognosis and quality of life for patients. However, early neurological symptoms can be subtle and easily confused with other neurological conditions, leading to diagnostic delays. In this context, magnetic resonance imaging (MRI) plays a fundamental role in the timely identification of this pathology.

Diving Deeper into Early Diagnosis

Initial symptoms of glioblastoma may include persistent headache, epileptic seizures, and focal neurological signs. In some cases, patients may present personality changes or psychiatric symptoms, further complicating the differential diagnosis. A case study highlighted how subtle neuropsychiatric symptoms can be mistakenly diagnosed as depression, emphasizing the need for comprehensive diagnostic evaluation, including neuroimaging, to rule out the presence of a tumor [32188609].

MRI is more sensitive than computed tomography for detecting intracranial lesions. In the early stages, glioblastoma may present with hyperintense areas on T2-weighted sequences and no enhancement after gadolinium administration, which can mimic non-neoplastic lesions [17895617]. However, radiographic progression can become evident in a short period, highlighting the importance of performing follow-up MRI at short intervals in adult patients presenting with epileptic seizures or new neurological deficits [19168996].

Additionally, the presence of peritumoral edema on preoperative MRI has been identified as an independent prognostic factor, suggesting that early radiological characterization may contribute to more targeted subgroup treatment in patients with glioblastoma [19473360].

Conclusions

Early diagnosis of glioblastoma is challenging due to the variability of its initial clinical presentations. Magnetic resonance imaging is an invaluable tool for detecting subtle changes in the brain that may indicate the presence of glioblastoma in its early stages. Close monitoring and the use of follow-up MRI are essential for identifying tumor progression as early as possible, thus allowing for early intervention and potentially improving patient prognosis. The integration of clinical evaluation with advanced imaging techniques and, when necessary, brain biopsy, remains the gold standard for accurate diagnosis of this devastating disease.

Referencias

• [1] Subtle neuropsychiatric symptoms of glioblastoma multiforme misdiagnosed as depression.
• [2] Early neuroimaging findings of glioblastoma mimicking non-neoplastic cerebral lesion.
• [3] Early appearance of high grade glioma on magnetic resonance imaging.
• [4] Peritumoral edema on MRI at initial diagnosis: an independent prognostic factor for glioblastoma?.

Created 13/1/2025