Supratentorial Glioma Manifesting as Acute Onset of Pure Motor Hemiparesis —Case Report

A 68-year-old male presented with an anaplastic astrocytoma deep in the sensorimotor cortex manifesting as acute pure motor hemiparesis suggestive of a vascular mechanism rather than tumor mass effect. Perfusion-weighted magnetic resonance (MR) imaging showed a significant decrease of blood flow in the sensorimotor area, where fluid-attenuated inversion recovery imaging demonstrated a prominently edematous area. Angiography also suggested ischemia with poor visualization of the precentral and central arteries. Diffusion-weighted MR imaging failed to identify the edema as cytotoxic or vasogenic due to technical problems. Brain tumors may manifest through impairment of peritumoral blood supply, which can be clarified by recent MR methods.