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High Grade Glioma

Last Updated: September 28, 2018

Figure 1: A patient of Harvey Cushing underwent a right parietal craniotomy in 1926 without any remarkable intraoperative findings.  Preoperatively, the child was suffering from progressive left-sided hemiparesis. No superficial abnormality was found in surgery. The patient subsequently continued to worsen neurologically: decorticate posturing (upper image-taken by Cushing’s resident-Davidoff). Autopsy brain specimen revealed a thalamic high-grade glioma (Courtesy of Cushing Brain Tumor Registry at Yale University).

High-grade gliomas (HGGs) originate either de novo from glial cells or from low-grade gliomas that dedifferentiate into higher-grade tumors. High-grade gliomas (WHO grade III & IV) include anaplastic astrocytomas, anaplastic oligoastrocytomas, glioblastoma multiforme (GBM), gliosarcomas, and anaplastic oligodendrogliomas.

Primary and secondary GBMs carry distinct...