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Monday, August 29, 2011

POSTERIOR FOSSA NHL


58 yr old lady presented with c/c
  • Vertigo -4 weeks
  • Diplopia , right sided hearing impairment and tinnitus, gait ataxia-3 weeks
  • No history s/o facial asymmetry, lower cranial neuropathy
  • No h/o headache, vomitings, seziures, motor/sensory deficits
  • Known h/o HT-on regular treatment

EXAMINATION

  • Fundii-no pappilodema
  • Right ptosis
  • Gaze evoked nystagmus
  • Right 6th, right 8th nerve paresis
  • Right cerebellar signs





INVESTIGATIONS

  • Pure tone audiometry-lower frequency moderate loss of hearing on right side
  • MRI brain-B/L cerebellopeduncular and vermian lesions
  • PET scan-increase uptake in bilateral cerebellopeduncular and vermis

TREATMENTS

  • Right retrosigmoid craniotomy with microsurgical tumor decompression of right cerebellar peduncle lesion done under GA on 19.07.2011
  • Findings-greyish, soft to firm, intraaxial, mildly vascular, infilterating lesion attached to 7th, 8th nerve root entry zone, tumor attached to brainstem and cranial nerves left, rest excised

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