An inexpective adult diffuse astrocytoma: Case report and literature review

Abstract

Background: Diffuse gliomas in adults also include astrocytoma and isocitrate dehydrogenase deficiency, oligodendrogliomas with 1p/19q deletion, and also glioblastoma, wild type (IDH). As indicated in the European guidelines on low-grade I gliomas, early extensive surgical resection may be associated with a good prognosis.  Molecular markers show that IDH1 R132H has a prognostic role in GBM. Temozolomide chemoradiation has shown beneficial results in the survival of patients with astrocytoma. Case description: A 76-year-old woman presented to our emergency room; according to her family and emergency medical team, the patient fell at home and received a direct blow to the head with loss of consciousness. The patient had a known history of hypertension for a few years and was taking antihypertensive medications periodically. Unspecified leukaemia. Respiratory rate: 16/min; respiratory rate: regular. On clinical examination, the patient is conscious, oriented, and has right-sided weakness. Glasgow GCS (points): 11 points. after a profound, stunning. Contact is very difficult due to speech disorders. (Dysarthria). He has a right hemiparesis of 2 points, with a Positive Babinski sign on the right side. Conclusion: The case highlights the importance of multimodal management, including early surgical intervention, molecular diagnostics, and postoperative care, in improving outcomes for patients with astrocytomas. A review of prognostic factors, such as age, GCS scores, and molecular markers like IDH1 mutations, emphasises the need for individualised treatment approaches. Although advances in chemoradiation, particularly with temozolomide, have improved survival rates, astrocytomas remain associated with high morbidity and mortality. This report underscores the critical role of early diagnosis, maximal safe resection, and tailored therapeutic strategies in optimising patient outcomes and quality of life.