Dawaa Reference

chronic

Malignant Neoplasm of the Nervous System

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Glioblastoma Multiforme - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK558954/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class ND25.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • What it does depends on where the tumour sits and how big it is, and it looks like any other brain tumour
  • Neurological symptoms build up over days to weeks
  • The symptoms are vague and overlap with infection and inflammation, so suspicion has to be kept high
  • How it declares itself: raised pressure inside the skull 30%, weakness 20%, seizures 20%, altered awareness 17%, confusion 15%, visual loss 13%, speech difficulty 13% [confusion · loss of vision · seizures]
  • Location: above the tentorium in 85%, the frontal lobe in about a quarter, brainstem and spinal cord under 5% each, cerebellum under 3%

Signs — what you find (1)

  • On examination a fifth have weakness, and around one in eight have a visual or speech deficit, with awareness altered in 17%

Tests (6)

  • On MRI the lesion has ragged edges and enhances at its rim because the blood-brain barrier has broken down
  • The centre is dark on T1 because it is dead tissue, and the rim is bright on T2 and FLAIR because of surrounding swelling
  • Perfusion imaging shows increased blood flow from the new vessels the tumour grows
  • MR spectroscopy characteristically shows a choline peak
  • Only histopathology settles the diagnosis
  • The tissue is then tested for GFAP, IDH mutation status and MGMT promoter methylation

If not this — what else fits (9)

  • A single secondary deposit in the brain
  • Primary lymphoma of the central nervous system
  • Brain abscess
  • A stroke, ischaemic or haemorrhagic, at the subacute stage
  • A resolving brain contusion
  • Demyelination in its mass-forming form
  • Radiation necrosis
  • A vascular malformation
  • Cerebral toxoplasmosis

SourceStatPearls "Glioblastoma Multiforme" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Primary malignant CNS tumours such as glioblastoma or high-grade astrocytoma; the GP's role is urgent recognition and oncology/neurosurgery referral, with dexamethasone for cerebral oedema and analgesia for symptom control while the patient is worked up. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Primary malignant CNS tumours such as glioblastoma or high-grade astrocytoma; the GP's role is urgent recognition and oncology/neurosurgery referral, with dexamethasone for cerebral oedema and analgesia for symptom control while the patient is worked up.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - A rapidly progressive focal neurological deficit, a new seizure, or signs of raised intracranial pressure such as early morning vomiting or papilloedema.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.