Stroke as initial misdiagnosis of glioma

Computed tomography (CT) and magnetic resonance (MR) imaging have significantly improved the diagnosis of brain tumors. However, brain tumor is still sometimes difficult to distinguish from stroke in patients presenting with acute neurological symptoms. Four hundred and two patients with glioma received initial treatment at our hospital from June 1995 through May 2005. Among these patients, 8(2.0%) were initially treated under a misdiagnosis of stroke. Brain CT and MR imaging at onset, and angiographical examinations in some of these 8 patients, failed to detect the tumor. The misdiagnosis was intracerebral hemorrhage in 3 patients, subarachnoid hemorrhage in 1, and cerebral infarction in 4. Early and accurate diagnosis can lead to better outcome in patients with glioma. Meticulous follow up of similar patients using MR imaging may improve the diagnostic accuracy and therapeutic outcome.