Right Posterior Communicating Artery Aneurysm

HISTORY: -

35 yr old gentleman presented with c/c of:-

Sudden onset of headache followed by neck stiffness, vomitings and drowsiness

EXAMINATION:-

•           BP-220/120 mm
•           GCS-E3V5M6
•           NO DEFICITS

 

TREATMENT:-

Right fronto-temporal trephine craniotomy with aneurysmal clipping done

 

POST-OPERATIVE CT SCAN HEAD:-

POST-OPERATIVE COURSE:

Sensorium same as pre-operatively, maintaining vitals, still under treatment.

Left parieto-occipital trephine crniotomy with radical tumor

HISTORY

11 yr old boy presented with c/c

• Headache-1 year
• Right vision loss-1 month

EXAMINATION

• Bilatearl mild papillodema
• Right direct light reflex absent
• Right vision-light preception only in nasal half, left-6/9
• Left nasal hemifield defect

INVESTIGATIONS

TREATMENT

• Left parieto-occipital trephine crniotomy with radical tumor removal done under GA

POST-OPERATIVE PERIOD

• Headache releived, no improvement in right vision

HISTOPATHOLOGY

• Highly malignant-Epithileal origin

POST-OPERATIVE CT SCAN HEAD

Recurrent Craniopharyngioma

History:-

14 yr old boy, Pitiutary Dwarf follow-up operated for Craniopharyngioma in 2001, 2008, 2009 now presented with

• Headache
• Decreased vision

On Minirin puff, Wyselone and Eltroxin

Examination : -

• B/L Primary Optic Atrophy
• B/L Visual acuity-6/9
• Bitemporal Hemianopia

Investigations :-

Treatment :

• Right Frnto-temporal Trephine Craniotomy with tumor decompression done under GA

Post-Operative Period :-

• Uneventful

Post Operative Scan :-

Intra Fourth Ventricular Tumor

HISTORY:-

25 YR old gentleman r/o Iraq, presented with c/c of:-

• Vomitings-6 months
• Headache-4 monhts
• Gait ataxia-1 month
  
  On steroids since last one month, imorvement in sympotomatology

EXAMINATION:-

• Nystagmus
• Impaired tandem walking

INVESTIGATIONS:-

• MRI Brain

TREATMENT:-

Suboccipital craniectomy with tumor decompression done

INTRA-OPERATIVE FINDINGS:-

• Soft, suckable, intra fourth ventricular tumor attached to dorsal brainstem

HISTOPATHOLOGY:-

• Anaplastic Ependymoma

POST-OPERATIVE PERIOD:-

• Having lower cranial nerve paresis post-operatively along with diplopia, gradually improving.

A.com Aneurysm

History:-

38 yr old gentleman admitted with c/c of

· Sudden onset of severe occipital headache 1 day back, associated with stiffness of neck

· No significant past history

Examination:-

· WFNS grade-1

· Neck rigidity

Investigations:-

· NCCT head showed diffuse SAH, Fisher grade-3

· CT angiography-A.Com. aneursm with right A1 hypoplasia

Treatment:-

· Left fronto-temporal trephine craniotomy with aneurysmal clipping done under GA

Post-operative period:-

· Uneventful

INTRAVENTRICULAR TUMOR

20 yr old boy admitted with c/c of:-

· Headache-7 days

EXAMINATION-

· Pappilodema

· No neurological deficits

INVESTIGATIONS-

TREATMENT-

· Left parieto-temporal trephine craniotomy with tumor decompression done

HISTOPATHOLOGY-

· Glioblastoma Multiformae

Awake Craniotomy

History:-

26 yr old gentleman admitted with c/c of:-

• Right focal seizures-14 months

Examination:-

• No neurological deficits

Investigations:-

• MRI brain showed left frontal hypointense lesion with mild enhancement with perifocal edema in premotor cortex

Treatment:-

• Awake craniotomt with gross total excision done under local anasthesia and sedation

Post-operative period:-

• No neurological deficits

Post-operative CT scan head