spot the diagnosis&management

58yrs female Pt had sudden loss of consciousness and Right hemeperesis. Admitted give hospital for 3-4 days then referred to mamata hospital. Gcs at presentation was E1V1M5 Pupils left side mid dilated sluggish to light, right side normal reactions to light.

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A large space occupying lesion - most likely Glioma - occupying left temporo-,parietal ND frontal region with gross midline shift towards left side. A SPECT - CT and MRI is indicated for further evaluation before neurosurgical intervention and excision. Prognosis always remains guarded in such cases- even after surgery

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Left MCA stem occlusion with midline shift uncal herniation to right

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It's ICSOL,refer to neurosurgeon

Malignant left MCA territory infarction with significant mass effect and midline shift

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