18 year young male presented to emergency opd with unconsciousness since 3 days and dilated pupil(3mm). h/o severe headache and blurred vision and vomitting. what is your diagnosis?? treatment plan??
D/D - Pilocystic Astrocytoma Haemangioblastoma Brain abscess Tuberculoma Parasitic- hydatid cyst, amoebic , cysticercosis Non malignant cyst Metastatic lesion Treatment- Reduce brain oedema with steroids. A Biopsy is the mainstay of diagnosis and further
Cyst with mural nodule CMN Tumour D/d hemangioblastoma pilocytic astrocytoma, ganglioglioma, pleomorphic xanthoastrocytoma[4]and, as less common, tanycytic ependymoma, intraparenchymal schwannoma, desmoplastic infantile ganglioglioma and cystic metastasis
Boy needs urgent craniotomy and decompression of sol. Diagnosis will be clear once u take a sample intraop and send it for biopsy or culture. If condition permits CEMRI brain before surgery will help a lot in diagnosis and surgical approach.
Large left frontal cystic lesion with gross midline shift. D/D abscess, cystic glioma or parasitic cyst craniotomy with excision of lesion or aspiration of cystic fluid . Contracst MRI
SOL with perifocal edema giving finger like projection doesn't appear as cystic mass
Abscess unlikely. No wall enhancement on contrast ct. also. Solid portion is quite significant in top vertex cuts. Decongestants followed by urgent surgery with excision. If time and facility permits,Then cemri with mrs D/d CYSTIC MENINGIOMA. DNET. PILO ASTRO.
Left frontal Cystic astrocytoma with perilesion oedema with uncal herniation. Compressio of RT lateral ventricle with mild dialtation of posterior horn of rt lateral ventricle. Start-antiepileptic,cerebral oedema measures,Urgent Neurosurgical consultation
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