A Rare Case of Cerebellar Glioblastoma Mimicking Acute Stroke in an Elderly Patient

Patient: Female, 82-year-old Final Diagnosis: Cerebellar glioblastoma Symptoms: Dizziness Medication: — Clinical Procedure: — Specialty: Neurology OBJECTIVE: Unusual clinical course BACKGROUND: Glioblastoma (GB) is a common brain tumor that usually presents in the cerebral hemisphere. Very rarely, these tumors can present in the cerebellum. The tumor tends to have a diffuse infiltrative growth that follows the white-matter pathway. Cerebellar GB is often difficult to diagnose on imaging and a biopsy is often needed for diagnosis. Here, we present the case of an elderly woman who presented with symptoms suggestive of acute stroke. CASE REPORT: An 82-year-old woman presented for intermittent dizziness that started 2 weeks prior to the presentation and had been progressively worsening. She had a prior history of stroke and was noted to have decreased motor strength and sensation to touch on the left side. A cranial nerve examination was normal, as was finger-nose testing. Magnetic resonance imaging (MRI) of the brain with and without contrast showed an enhancing lesion in the left posterior cerebellum producing a mass effect in the left lateral ventricle. The differential diagnosis included cerebellitis with abscess, neoplastic process with necrosis, and, less likely, a sub-acute infarction A suboccipital craniotomy with cerebellar biopsy-diagnosed cerebellar GB. CONCLUSIONS: We report the unique presentation of cerebellar GB in an elderly woman who presented with left-sided weakness, elevated blood pressure, dizziness, vasogenic edema in the left cerebellum, and a mass effect on the fourth ventricle, mimicking acute stroke.