Garcia Debora González, Casas Miguel Ángel González, Martínez Martin Heisi Gómez
Department of Internal Medicine, Regional General Hospital No. 1 of Queretaro, Queretaro, Mexico.
Neurology Department, Institute of Security and Social Services for State Workers, Saltillo, Coahuila, Mexico.
Case Rep Neurol Med. 2024 Nov 28;2024:3375867. doi: 10.1155/crnm/3375867. eCollection 2024.
Gliomatosis cerebri (GC) is a diffuse neoplastic process, whose presentation is extremely rare and lacks a characteristic clinical pattern. The objective of this case is to describe the clinical aspects of a patient with GC, in whom symptoms of parkinsonism and neurocognitive issues predominate. A 78-year-old patient with no significant medical history was referred to the neurology consultation due to balance disturbances accompanied by head tremor. Symptoms of parkinsonism progressively worsened, adding cognitive and neuropsychiatric disorders. Cranial magnetic resonance imaging (MRI) showed diffuse and generalized white matter hyperintensity. Under the suspicion of GC, a frontal lobe biopsy was performed, with a pathology report of diffuse astrocytoma, thus confirming the diagnosis of GC. GC is a disease that presents with nonspecific clinical manifestations, making a clinical diagnosis challenging. It should be suspected in cases of parkinsonism accompanied by other focal neurological disorders. This leads to delayed diagnosis and consequently low incidence. The importance of MRI as a diagnostic aid is highlighted, with biopsy being necessary to confirm the diagnosis.
大脑胶质瘤病（GC）是一种弥漫性肿瘤性病变，其表现极为罕见且缺乏特征性临床模式。本病例的目的是描述一名以帕金森症状和神经认知问题为主的GC患者的临床情况。一名无重大病史的78岁患者因平衡障碍伴头部震颤被转诊至神经内科会诊。帕金森症状逐渐恶化，并出现认知和神经精神障碍。头颅磁共振成像（MRI）显示弥漫性和全身性白质高信号。在怀疑为GC的情况下，进行了额叶活检，病理报告为弥漫性星形细胞瘤，从而确诊为GC。GC是一种临床表现不具特异性的疾病，临床诊断具有挑战性。在伴有其他局灶性神经系统疾病的帕金森病病例中应怀疑此病。这导致诊断延迟，因此发病率较低。强调了MRI作为诊断辅助手段的重要性，确诊需要进行活检。
