A 61-Year-Old Thai Male Patient Came with Confusion 2 Days before Coming to the Hospital

Abstract

A 61-year-old  Thai male patient in Chonburi province came with confusion 2 days before coming to the hospital.

4 days ago, relatives gave a history of weakness on the left side after waking up, lifting a spoon of rice and falling. There is no crooked mouth, still talking about things.

2 days ago, the patient present confused and fever.

V/S BT 38.6 C, spo2 93-94%, BP 152/88 mmHg, PR 96/min

Oriented to time place and person

E4M6V5, pupil 3 mm, RTLBE, no facial palsy, decreased pinprick sensation, right side of the face, tongue deviation to the right, motor power grade V/V all except the right leg IV/III, decrease in pinprick sensation in the right thigh and leg

CT brain: 2.4 x 3.0 x3.1 well-defined heterogeneous extra-axial mass with extensive surrounding vasogenic edema involving left frontal and parietal lobes, corpus callosum, left internal capsule, and external capsule, causing mass effect, rightward midline shift

MRI brain as shown

The Histological section as picture below

Question 1: Give a diagnosis

Question 2: Tell me about course of the disease

Question 3: Describe the syndromes you may experience