Glioblastoma Clinical Presentation

Updated: Mar 07, 2023
  • Author: Jeffrey N Bruce, MD; Chief Editor: Herbert H Engelhard, III, MD, PhD, FACS, FAANS  more...
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The clinical history of patients with glioblastoma (GBM) is usually short, spanning less than 3 months in 68% of patients and < 6 months in 84% of patients. [4] Note the following:

  • The most common presenting symptoms of GBM are seizure and cognitive disorder. [5]
  • Other common presenting symptoms include slowly progressive focal neurologic deficits, such as motor weakness, sensory loss, memory loss, language deficits, and visual impairments. [6]
  • Alternatively, patients may present with generalized symptoms of increased intracranial pressure (ICP), including headaches, nausea and vomiting, and personality changes. [6]
  • A minority of patients present with stroke-like symptoms and signs following intratumoral/intracranial hemorrhage. [2]
  • In general, the three histologic subtypes—giant cell glioblastoma, gliosarcoma, and eplthelioid glioblastoma—present similarly. [2]

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:

  • Changes in personality, mood, mental capacity, and concentration can be early indicators or may be the only abnormalities observed.
  • Common focal neurologic signs and symptoms include hemiparesis, sensory loss, visual loss, and aphasia.
  • Headaches can vary in intensity and quality but tend to be exacerbated by lying supine and are thus usually more severe upon first awakening or in the early morning; they may be induced by asking the patient to cough or perform the Valsalva maneuver. [6]
  • Headache along with a new neurologic deficit (particularly cognitive impairment or focal weakness) significantly increases the likelihood of an underlying brain tumor. [156]