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Symptomatic raised intracranial pressure / mass effect in glioblastoma: declining GCS, ne...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-GBM-INTRACRANIAL-PRESSURE-EMERGENCY
TypeRed flag
Statusreviewed 2026-04-26 | pending_clinical_signoff
DiseasesDIS-GBM
SourcesSRC-EANO-GBM-2024 SRC-NCCN-CNS-2025

Red Flag Origin

DefinitionSymptomatic raised intracranial pressure / mass effect in glioblastoma: declining GCS, new focal deficit, papilledema, midline shift on imaging, or seizure cluster. Mandates immediate neurosurgical / corticosteroid intervention BEFORE oncologic systemic therapy.
Clinical directionhold
Categoryorgan-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "finding": "gcs_declining",
      "value": true
    },
    {
      "comparator": ">=",
      "finding": "midline_shift_mm",
      "threshold": 5
    },
    {
      "finding": "uncontrolled_seizure_cluster",
      "value": true
    },
    {
      "finding": "new_focal_deficit",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

Mass effect emergency — dexamethasone 8-16 mg IV stat, neurosurgical consult for resection / debulking / VP shunt. Anti-epileptics for seizure cluster (levetiracetam preferred — no enzyme induction vs older AEDs that interfere with TMZ pharmacokinetics).

Used By

Indications