We present multicentric glioblastomas radiologically mimicking metastatic tumors. A 57-year-old female presented with multiple brain masses accompanied by generalized seizures. Since there was no primary lesion considered to be the origin, the patient underwent craniotomy to remove the mass. The mass was pathologically diagnosed as glioblastoma, IDH-wildtype. When we found a multicentric tumor mass in the brain, a metastatic tumor was first suspected, and radiotherapy without surgical resection was believed to be acceptable. However, glioblastoma, which requires intensive chemoradiotherapy, rarely demonstrates multiple lesions as in the presented case. Therefore, surgical resection should be considered to make a diagnosis and treat multiple brain tumors, especially in cases with no certain primary lesion.
The coronavirus disease 2019 (COVID-19) epidemic has had a major impact on stroke treatment. The acute ischemic stroke (AIS) treatment protocol at our hospital now requires a rapid antigen test on arrival to prevent the spread of COVID-19 infection, so the initiation of treatment may be delayed. We compared AIS treatment before (October 2018 to March 2020) and after the epidemic started (April 2020 to September 2021) to investigate the effect of COVID-19. The number of AIS emergency transports was 73 before and 102 after the epidemic. The time from door to image time was significantly extended ( p < 0.05). However, door-to-puncture time and puncture-to-recanalization time showed no significant changes. Possibly our revision of the protocol, such as omitting some imaging examinations, including magnetic resonance imaging, enabled more rapid interventions.
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