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MEDULLOBLASTOMA Pediatric posterior fossa tumour
Medulloblastoma- Pedatric posterior fossa tumor
13 YRS OLD MALE PRESENTED WITH HISTORY OF HEADACHE AND VOMITING FOR LAST ONE MONTH & WALKING DIFFICULTY
H/O MILD HEADACHE ON AND OFF FOR LAST 6 MONTHS.
ON EXAMINATION HE WAS CONSCIOUS & HAD GCS 15/15
HAD BILATERAL PAPILLEDEMA WITH TRUNCAL ATAXIA
PATIENT WAS INITIALLY EVALUATED AT PERIPHERAL HOSPITAL AND SHIFTED TO OUR HOSPITAL FOR FURTHER MANAGEMENT
INVESTIGATED WITH MRI SCAN WHICH SHOWED AN POSTERIOR FOSSA INTRA FOURTH VENTRICULAR LESION WHICH WAS MINIMALLY ENCHANCING ON CONTRAST WITH MILD PERILESIONAL EDEMA WITH MILD OBSTRUCTIVE HYDROCEPHALUS.
PATIENT UNDERWENT SPINAL SCREENING WHICH SHOWED TO HAVE DROP METS ALREADY
PATIENT UNDERWENT MIDLINE SUBOCCIPITAL CRANIOTOMY AND TRANSVERMIAN APPROACH NEAR TOTAL EXICSION OF TUMOUR
SURGICAL PEARLS-POSITION-USE CONCORD POSITION WITH HEAD ABOVE HEART LEVEL
BASIC REQUIREMENTS- THREE PIN FIXATOR,GOOD SUCTION AND CAUTERY SYSTEM, HIGH SPEED DRILL,ULTRASONIC ASPIRATOR,NEURONAVIGATION, MICROSCOPE(+/_ TUMOUR FLUROSCENE)
GOOD LEYLA RETRACTOR SYSTEM, NON-STICKING BIPOLAR FORCEPS
USE TOTAL INTRAVENOUS ANAESTHESIA WITH GOOD ANESTHESIC TEAM,GOOD ICU BACKUP TEAM
OPTION CAN BE CONTINUING ELECTIVE VENTILATION OVER NIGHT AND EXTUBATE AFTER CT SCAN NEXT MORNING.
POST-OP PATIENT WAS NEUROLOGICALLY NORMAL AND HAD NO HEADACHE
POST-OP CT SCAN SHOWED GOOD DECOMPRESSION OF TUMOUR WITH NO RESIDUE OF LESION AND OPENED CSF PATHWAYS.
PATIENT HAD MILD RESIDUAL LEFT UPPER LIMB AND LOWER LIMB CERBELLAR SIGNS
2 WEEKS POST-OP SCAN WAS BETTER DELIENEATED IN THE AREA OF THE SURGICAL EXICISION OF TUMOUR.
POST-OP PATIENT HAS MADE COMPLETE IMPROVEMENT.
HPR- MEDULLOBLASTOMA
PLEASE CONTACT FOR ANY QUERIES
COMPLETE BRAIN AND SPINE CARE UNDER COMPHRENSIVE MANAGEMENT BY EXPERTS IN THE FIELDS LED BY DR.RAVIRAJ.GHORPADE UNDER ONE ROOF
BHS LAKE VIEW GROUP OF HOSPITALS,
BELGAUM,KARNATAKA, INDIA
ONLY TERITARY CARE HOSPITAL FOR ENDOSCOPIC PROCEDURES DONE IN ALL SPECIALITES OF NEUROSURGERY,E.N.T, GASTRO-ENTEROLOGY,JOINT ARTHOSCOPY,UROLOGY,GYNAECOLOGY
Contact- neuroraviraj@rediffmail.com , +91-8762996508
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