Injured glioma syndrome: report of a case with unfavorable outcome

Abstract

Introduction: Wounded Glioma Syndrome (WGS) is a clinical picture described after resection of high-grade tumors. It is characterized by the presence of hemorrhage and postoperative edema that is difficult to manage, leading to significant sequelae and in some cases death. Pre and postoperative conditions play an important role in WGS, as well as factors related to surgery such as modification of tumor and peritumoral blood flow, altered coagulation, among others. Clinical case: 12-year-old patient with a diagnosis of anaplastic astrocytoma who underwent partial surgical resection, without presenting complications. At 48 hours, the patient presented clinical signs of intracranial hypertension, the brain tomography revealed bleeding in the surgical bed and significant perilesional edema. Barbiturate coma, neuroprotective measures, and anti-edema treatment were induced. The patient remained in the ICU for 23 days, leaving the ICU on a 5-point Glasgow Coma Scale, dependent on mechanical ventilation so far. Conclusion: This case shows the rapid deterioration and important sequelae that a patient with glioma surgery can present. Complete resection is not always possible. Therefore, when faced with incomplete resection or a biopsy, neurosurgeons must consider this syndrome, as well as its implications and repercussions in the immediate postoperative period; To assess the risk/benefit when planning surgery and act early, if this syndrome occurs. Keywords: Glioma, Astrocytoma, Hemorrhage, Edema, Intracranial Hypertension, (Source: MeSH NLM)