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A 69-year-old man presented to our hospital with an acute aphaisa. The patient had
experienced headaches 27 months before this presentation and a magnetic resonance
image (MRI) had been normal at that time. After a normal unenhanced head computed
tomography (CT) scan was obtained, he received intravenous tissue plasminogen activator
(t-PA) within 2 hours of the onset of his symptoms. The patient gradually improved,
but on day 13, post t-PA–increased somnolence was noted. A repeat head CT scan showed
acute hydrocephalus and a mass. The tumor did not respond to radiation treatment and
the patient died 39 days after the initial presentation.
Fig. 1Unenhanced CT scans at days 0, 1, 9, and 13 after t-PA administration, and a normal
MRI scan performed in 1996 (27 months before presentation). This pathological specimen
shows the glioblastoma multiforme in the left hemisphere.
*Address reprint requests to: Hans H. Klüenemann, MD, University of Regensburg School of Medicine, Department of Psychiatry, Universitatsstr 84, D-93053, Regensburg, Germany.
