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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
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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