A
24-year-old male was admitted to emergency department with personality changes
and long-lasting headache. Neurologic examination did not show any
abnormalities. In cranial computed tomography scan brain mass was detected in
frontal cortex bilaterally. Patient was hospitalized in Neurosurgery clinic with
a diagnosis of intracranial tumor. Elective tumor resection was performed and
his topathologic examination was reported as glioblastoma multiforme. In
follow-up, no personality changes were observed. Patients with personality
changes shouldbe examined carefully,
besides possible frequent underlying pathologies, intracranial tumors must be
considered in differential diagnosis. Long lasting headaches may be a clue for
emergency physicians.
1. Tolgay E, Bahar A, Yurtoğulları Ş, Karlı N, Erer S, Turan F ve ark. Multisentrik Glioblastoma Multiforme Olgusu. Türk Nörol Derg 2008;14(4):272-76.
2. Dağıstan Y, Dağıstan E, Güney MS. Sebepsiz kişilik değişiklikleri ile başlayan glioblastome multiforme: Bir olgu sunumu. Abant Med J 2012;1(1):23-25.
3. Matschke J, Tsokos M. Sudden Unexpected Death due to Undiagnosed Glioblastoma: Report of three cases and Review of the Literature. Acta Neurochir Suppl 2003;86:507-11.
4. Frederiks J. Transient globalamnesia. Clin Neurol Neurosurg 1993;95(4):265-83.
5. Parlayan ET. Geçici global amnezi ve demansiyel bulgular ile başlayan glioblastoma multiforme olgusu. Klinik Psikiyatri 2010;13:209-14.
6. Levin VA, Sheline PH, Gutin PH: Neoplasms of central nervous system, in de Vita, Helman VTS, Rosenberg SA (eds): Cancer. Principles and Practice of Onkology, vol 2, 3rd ed. Philadelphia: Lippincott, 1989:1557-612.
7. Eroğlu C, Soyuer S, Yıldız OG, Özkan M, Menkü A, Orhan O ve ark. Glioblastoma multiforme’li olgularda postoperatif radyoterapi ile eş zamanlı temozolomide adjuvan temozolomid ilavesinin tedavi sonuçlarına katkısı. UHOD 2008;18:65-73.
8. Reni M, Cozzarini C, Ferreri AJM, Ceresoli GL, Galli L, Bianchi A, et al. A retrospective analysis of postradiation chemotherapy in 133 patients with glioblastoma multiforme. Cancer Invest 2000;18:510-5.
9. Brada M, Sharpe G, Rajan B, Britton J, Wilkins PR, Guerrero D, et al. Modify in radical radiotherapy in high grade gliomas; Shortening the treatment time through acceleration. Int J Radiat Oncol BiolPhys 1999; 43:287-92.
10. Dere F. Nöroanatomi. 1. Baskı, Adana: Ç.Ü. Basımevi, 1990;10-113.
11. Levin A, Leibel SA, Gutın PH. Neoplasms of the CentralNervous. De Vita VT, Hellman S, Rosenberg SA Cancer Principles and Practice of Oncology. 5th ED, Philadelphia: J.B Lippincot-Raven Publıshers, 1997:2022-83.
12. Karlsson UL, Leibel SA, Wallner K, DavisLW, Brady LW, Brain in: Principles andPractise of Radiation Oncology. (eds) : Perez CA, Brady LW,J.B Lippincot Company Philadelphia:1992, ch23:513-63.
13. Karlsson UL, Leibel SA, Wallner K, DavisLW, Brady LW. Primary intracranial Neoplasms. Perez CA, Brady LW. Principles and Practise of Radiation Oncology. Third ED, Philadelphia: J.B Lippincot Company 1998 :777-822.
14. Demir MK, Hakan T, Okan Akıncı, Berkman Z. Primer serebellar glioblastoma multiforme. Diagn Interv Radiol 2005;11:83-6.
15. Mayadağlı A, Tezcan Y, Uyanoğlu A, Aksakal Ö, Kızılkaya O, Erkal H ve ark. Konvansiyonel eksternal radyoterapi uygulanan glioblastoma multiforme tanılı 40 hastanın irdelenmesi. Genel Tıp Dergisi 1997;7:121-3.
16. Chang CH, Horton J, Schoenfeld D, Salazer O, Perez-Tamayo R, Kramer S, et al. Comparison of postoperative radiotherapy and chemotherapy in the multidisciplinary management of malignant gliomas. Cancer 1983;52:997-1007.
17. Kristiansen K, Hagen S, Kollevold T,Torvik A, Holme I, Nesbakken R, et al. Combined modality therapy of operated astrocytomas Grade III and IV. Confirmation of the value of postoperative irradiation and lack of potentiation of bleomycin on survival time: a prospective multicentertrial of the Scandinavian Glioblastoma Study group. Cancer 1981;47:649-52.
18. Buatti JM, Marcus RB, Mendenhall WM, Friedman WA, Bova FJ. Accelerate hyperfractionated radiotherapy formalignantgliomas. Int J Radiat Oncol Biol Phys 1996;34:785-92.
19. Keim H, Potthoff PC, Schmidt K, Schiebusch M, Neiss A, Trott KR. Survival and quality of life after continuous accelerate dradiotherapy of glioblastomas. Radiother Oncol 1987;9:21-6.
Acil Serviste Nadir Görülen Bir Kişilik Değişikliği Nedeni: Glioblastoma Multiforme
Kişilik değişikliği ve uzun süredir
geçmeyen baş ağrısı şikâyeti nedeniyle 24 yaşındaki erkek hasta acil servise
başvurdu. Nörolojik muayenesinde patoloji saptanmayan hastanın çekilen kranial
bilgisayarlı tomografisinde bifrontal kitle ile uyumlu görüntü saptandı. Hasta
beyin cerrahisi servisine intrakraniyal kitle ön tanısıyla yatırıldı. Elektif
koşullarda tümör rezeksiyonu yapılan hastanın patoloji sonucu glioblastoma
multiforme olarak raporlandı. Hastanın takiplerinde kişilik değişikliği
saptanmadı. Kişilik değişikliği ile acil servise başvuran hastalarda altta
yatan ve risk oluşturan hastalıklar da göz önüne alınarak ayırıcı tanıda
kranial bir kitlenin varlığı akla getirilmeli. Uzun süreli şiddetli baş
ağrıları acil hekimine yol gösterici olabilir.
1. Tolgay E, Bahar A, Yurtoğulları Ş, Karlı N, Erer S, Turan F ve ark. Multisentrik Glioblastoma Multiforme Olgusu. Türk Nörol Derg 2008;14(4):272-76.
2. Dağıstan Y, Dağıstan E, Güney MS. Sebepsiz kişilik değişiklikleri ile başlayan glioblastome multiforme: Bir olgu sunumu. Abant Med J 2012;1(1):23-25.
3. Matschke J, Tsokos M. Sudden Unexpected Death due to Undiagnosed Glioblastoma: Report of three cases and Review of the Literature. Acta Neurochir Suppl 2003;86:507-11.
4. Frederiks J. Transient globalamnesia. Clin Neurol Neurosurg 1993;95(4):265-83.
5. Parlayan ET. Geçici global amnezi ve demansiyel bulgular ile başlayan glioblastoma multiforme olgusu. Klinik Psikiyatri 2010;13:209-14.
6. Levin VA, Sheline PH, Gutin PH: Neoplasms of central nervous system, in de Vita, Helman VTS, Rosenberg SA (eds): Cancer. Principles and Practice of Onkology, vol 2, 3rd ed. Philadelphia: Lippincott, 1989:1557-612.
7. Eroğlu C, Soyuer S, Yıldız OG, Özkan M, Menkü A, Orhan O ve ark. Glioblastoma multiforme’li olgularda postoperatif radyoterapi ile eş zamanlı temozolomide adjuvan temozolomid ilavesinin tedavi sonuçlarına katkısı. UHOD 2008;18:65-73.
8. Reni M, Cozzarini C, Ferreri AJM, Ceresoli GL, Galli L, Bianchi A, et al. A retrospective analysis of postradiation chemotherapy in 133 patients with glioblastoma multiforme. Cancer Invest 2000;18:510-5.
9. Brada M, Sharpe G, Rajan B, Britton J, Wilkins PR, Guerrero D, et al. Modify in radical radiotherapy in high grade gliomas; Shortening the treatment time through acceleration. Int J Radiat Oncol BiolPhys 1999; 43:287-92.
10. Dere F. Nöroanatomi. 1. Baskı, Adana: Ç.Ü. Basımevi, 1990;10-113.
11. Levin A, Leibel SA, Gutın PH. Neoplasms of the CentralNervous. De Vita VT, Hellman S, Rosenberg SA Cancer Principles and Practice of Oncology. 5th ED, Philadelphia: J.B Lippincot-Raven Publıshers, 1997:2022-83.
12. Karlsson UL, Leibel SA, Wallner K, DavisLW, Brady LW, Brain in: Principles andPractise of Radiation Oncology. (eds) : Perez CA, Brady LW,J.B Lippincot Company Philadelphia:1992, ch23:513-63.
13. Karlsson UL, Leibel SA, Wallner K, DavisLW, Brady LW. Primary intracranial Neoplasms. Perez CA, Brady LW. Principles and Practise of Radiation Oncology. Third ED, Philadelphia: J.B Lippincot Company 1998 :777-822.
14. Demir MK, Hakan T, Okan Akıncı, Berkman Z. Primer serebellar glioblastoma multiforme. Diagn Interv Radiol 2005;11:83-6.
15. Mayadağlı A, Tezcan Y, Uyanoğlu A, Aksakal Ö, Kızılkaya O, Erkal H ve ark. Konvansiyonel eksternal radyoterapi uygulanan glioblastoma multiforme tanılı 40 hastanın irdelenmesi. Genel Tıp Dergisi 1997;7:121-3.
16. Chang CH, Horton J, Schoenfeld D, Salazer O, Perez-Tamayo R, Kramer S, et al. Comparison of postoperative radiotherapy and chemotherapy in the multidisciplinary management of malignant gliomas. Cancer 1983;52:997-1007.
17. Kristiansen K, Hagen S, Kollevold T,Torvik A, Holme I, Nesbakken R, et al. Combined modality therapy of operated astrocytomas Grade III and IV. Confirmation of the value of postoperative irradiation and lack of potentiation of bleomycin on survival time: a prospective multicentertrial of the Scandinavian Glioblastoma Study group. Cancer 1981;47:649-52.
18. Buatti JM, Marcus RB, Mendenhall WM, Friedman WA, Bova FJ. Accelerate hyperfractionated radiotherapy formalignantgliomas. Int J Radiat Oncol Biol Phys 1996;34:785-92.
19. Keim H, Potthoff PC, Schmidt K, Schiebusch M, Neiss A, Trott KR. Survival and quality of life after continuous accelerate dradiotherapy of glioblastomas. Radiother Oncol 1987;9:21-6.