{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:56:50Z","timestamp":1769302610979,"version":"3.49.0"},"reference-count":15,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Glioblastoma multiforme (GBM) is a highly aggressive primary brain tumor with a poor prognosis. It commonly affects the brain and rarely spreads outside the central nervous system owing to barriers like the blood\u2013brain barrier. We present a rare case of GBM with atypical features mimicking autoimmune meningitis, complicating the diagnosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description<\/jats:title>\n<jats:p>A 45-year-old previously healthy man presented with persistent headaches, dizziness, vomiting, neck pain, diplopia from bilateral abducens nerve palsy, and cognitive dysfunction. The cerebrospinal fluid analysis did not confirm meningitis, although initial clinical and radiological findings suggested autoimmune meningitis. Head magnetic resonance imaging (MRI) showed postcontrast leptomeningeal enhancement and meningeal thickening. A spinal MRI revealed a contrast-enhancing lesion at the L1 level with leptomeningeal enhancement of the spinal cord. Despite empirical steroid therapy, his condition worsened, resulting in severe neurological deficits and impaired consciousness. A biopsy confirmed GBM through L1-2 laminectomy. Although adjuvant therapy was scheduled, his health rapidly declined, and he passed away on the 24<jats:sup>th<\/jats:sup> day of admission before receiving chemotherapy or radiotherapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>GBM can rarely present with noticeable symptoms and radiological features resembling autoimmune meningitis, posing diagnostic challenges. GBM cases involving spinal dissemination typically have a poorer prognosis, emphasizing the necessity of thorough diagnostic strategies. These should encompass histopathological biopsy and advanced imaging for optimal management, as delayed intervention significantly impacts survival. This report highlights the importance of maintaining a high level of suspicion for GBM and prompt intervention, including biopsy, in the presence of atypical clinical, radiological, and laboratory signs suggestive of meningitis.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_876_2024","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T09:50:28Z","timestamp":1740131428000},"page":"61","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Glioblastoma mimicking autoimmune meningitis in an adult: A complex diagnostic challenge"],"prefix":"10.25259","volume":"16","author":[{"given":"Mana","family":"Wakabayashi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Ina Central Hospital, Ina, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Ogiwara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ina Central Hospital, Ina, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoshi","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aizawa Hospital, Matsumoto, Ina, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ina Central Hospital, Ina, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Hanaoka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ina Central Hospital, Ina, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ina Central Hospital, Ina, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusaku","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ina Central Hospital, Ina, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiro","family":"Hongo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ina Central Hospital, Ina, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"10.25259\/SNI_876_2024\/ref-1","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.3390\/brainsci13111536","article-title":"Advances in glioblastoma therapy: An update on current approaches","volume":"13","author":"Angom","year":"2023","journal-title":"Brain Sci"},{"key":"10.25259\/SNI_876_2024\/ref-2","doi-asserted-by":"crossref","first-page":"489","DOI":"10.2176\/nmc.30.489","article-title":"Spinal cord glioblastoma multiforme with intracranial dissemination--case report","volume":"30","author":"Asano","year":"1990","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_876_2024\/ref-3","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S0009-9260(74)80168-6","article-title":"CSF seeding of intra-cranial tumours: A study of 96 cases","volume":"25","author":"Bryan","year":"1974","journal-title":"Clin Radiol"},{"key":"10.25259\/SNI_876_2024\/ref-4","doi-asserted-by":"crossref","first-page":"506","DOI":"10.21037\/apm-21-3387","article-title":"Clinical characteristics of glioblastoma with metastatic spinal dissemination","volume":"11","author":"Chen","year":"2022","journal-title":"Ann Palliat Med"},{"key":"10.25259\/SNI_876_2024\/ref-5","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s11060-014-1404-7","article-title":"Imaging guidelines and findings of extracranial glioblastoma","volume":"118","author":"Ginat","year":"2014","journal-title":"J Neurooncol"},{"key":"10.25259\/SNI_876_2024\/ref-6","doi-asserted-by":"crossref","first-page":"183","DOI":"10.14791\/btrt.2022.0013","article-title":"Leptomeningeal spread at the diagnosis of glioblastoma multiforme: A case report and literature review","volume":"10","author":"Jang","year":"2022","journal-title":"Brain Tumor Res Treat"},{"key":"10.25259\/SNI_876_2024\/ref-7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3988\/jcn.2016.12.1.1","article-title":"The diagnosis and treatment of autoimmune encephalitis","volume":"12","author":"Lancaster","year":"2016","journal-title":"J Clin Neurol"},{"key":"10.25259\/SNI_876_2024\/ref-8","doi-asserted-by":"crossref","first-page":"438","DOI":"10.3171\/2012.7.SPINE12212","article-title":"Leptomeningeal spinal metastases from glioblastoma multiforme: Treatment and management of an uncommon manifestation of disease","volume":"17","author":"Lawton","year":"2012","journal-title":"J Neurosurg Spine"},{"key":"10.25259\/SNI_876_2024\/ref-9","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s11060-014-1592-1","article-title":"Leptomeningeal dissemination in glioblastoma; an inspection of risk factors, treatment, and outcomes at a single institution","volume":"120","author":"Mandel","year":"2014","journal-title":"J Neurooncol"},{"key":"10.25259\/SNI_876_2024\/ref-10","doi-asserted-by":"crossref","first-page":"CASE23536","DOI":"10.3171\/CASE23536","article-title":"Spinal metastases of pineal region glioblastoma with primitive neuroectodermal features highlighting the importance of molecular diagnoses: Illustrative case","volume":"6","author":"Shah","year":"2023","journal-title":"J Neurosurg Case Lessons"},{"key":"10.25259\/SNI_876_2024\/ref-11","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.wneu.2020.08.086","article-title":"Glioblastoma multiforme: A rare case of spinal drop metastasis","volume":"144","author":"Sibanda","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_876_2024\/ref-12","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3389\/fonc.2020.00099","article-title":"Intracranial metastases originating from pediatric primary spinal cord glioblastoma multiforme: A case report and literature review","volume":"10","author":"Song","year":"2020","journal-title":"Front Oncol"},{"key":"10.25259\/SNI_876_2024\/ref-13","doi-asserted-by":"crossref","first-page":"250","DOI":"10.5114\/fn.2022.117267","article-title":"Atypical clinical presentation of glioblastoma mimicking autoimmune meningitis in an adult","volume":"60","author":"Stapi\u0144ska-Syniec","year":"2022","journal-title":"Folia Neuropathol"},{"key":"10.25259\/SNI_876_2024\/ref-14","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1227\/00006123-199010000-00002","article-title":"Brain stem and spinal metastases of supratentorial glioblastoma multiforme: A clinical series","volume":"27","author":"Vertosick","year":"1990","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_876_2024\/ref-15","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.clineuro.2010.12.001","article-title":"Glioblastoma multiforme at the corpus callosum with spinal leptomeningeal metastasis","volume":"113","author":"Witoonpanich","year":"2011","journal-title":"Clin Neurol Neurosurg"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/glioblastoma-mimicking-autoimmune-meningitis-in-an-adult-a-complex-diagnostic-challenge\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/glioblastoma-mimicking-autoimmune-meningitis-in-an-adult-a-complex-diagnostic-challenge\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:06:42Z","timestamp":1740132402000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/glioblastoma-mimicking-autoimmune-meningitis-in-an-adult-a-complex-diagnostic-challenge\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,21]]},"references-count":15,"alternative-id":["10.25259\/SNI_876_2024"],"URL":"https:\/\/doi.org\/10.25259\/sni_876_2024","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2025,2,21]]},"article-number":"61"}}