Undiagnosed High-Grade Glioma Leading to Sudden Death in a 38-Year-Old Female With a 4-Week History of Blurred Vision and Headache

Central nervous system (CNS) tumors, though relatively uncommon in the general population, frequently cause significant morbidity and mortality in those affected. Although high-grade neoplasms specifically may prove rapidly fatal, the rarity of these neoplasms-as well as their nonspecific symptomatology-renders them easily mistaken for both more common and innocuous etiologies. We report a case of a 38-year-old female with no significant medical history who sought care after 1 week of blurred vision and pressure-like headache worsened by leaning forward. Following antibiotic and oral steroid therapy for suspected acute sinusitis, she was found dead at home 3 weeks later. Autopsy revealed a 4.5-cm hemorrhagic and necrotic mass arising around and essentially effacing the third ventricle, further obstructing the cerebral aqueduct and causing bihemispheric mass effect. Histologic and immunohistochemical workup demonstrated a high-grade IDH-wildtype diffuse glioma. In this report, we review the uncommon clinical circumstance in which untreated intracranial neoplasms can prove rapidly fatal, salient clinical examination features to recognize such a condition, and the suggestions and limitations of leading neuroimaging criteria and guidelines for patients presenting with headaches.