Glioblastoma Multiforme Clinical Presentation

Updated: Jul 01, 2019
  • Author: Jeffrey N Bruce, MD; Chief Editor: Herbert H Engelhard, III, MD, PhD, FACS, FAANS  more...
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Presentation

History

The clinical history of patients with glioblastoma multiformes (GBMs) usually is short, spanning less than 3 months in more than 50% of patients, unless the neoplasm developed from a lower-grade astrocytoma. Note the following:

  • The most common presentation of patients with glioblastomas is a slowly progressive neurologic deficit, usually motor weakness. However, the most common symptom experienced by patients is headache.

  • Alternatively, patients may present with generalized symptoms of increased intracranial pressure (ICP), including headaches, nausea and vomiting, and cognitive impairment.

  • Seizures are another common presenting symptom.

Next:

Physical Examination

Neurologic symptoms and signs affecting patients with glioblastomas can be either general or focal and reflect the location of the tumor. General symptoms include headaches, nausea and vomiting, personality changes, and slowing of cognitive function. Note the following:

  • Headaches can vary in intensity and quality, and they frequently are more severe in the early morning or upon first awakening.
  • Changes in personality, mood, mental capacity, and concentration can be early indicators or may be the only abnormalities observed.
  • Focal signs include hemiparesis, sensory loss, visual loss, aphasia, and others.
  • Seizures are a presenting symptom in approximately 20% of patients with supratentorial brain tumors.
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