Concluded Case

Epidermoid cyst

new case pt. aged 32/m approached with c/o disoriented walking , he is unable to balance his walk especially lt. l/l o/e BP is 150/60 already on anti hypertensive medications reflexes of lt. l/l and u/l 3/5 while rt. l/l and u/l 5/5 Onset : present at the time of walking Duration >1 year now h/o htn and no type 2 dm advised MRI please find the same attached provide DX bad mgmt. @Dr. Manorama Rajan @Dr. Yashesh Dalal @Dr. Anand Kumar @Dr. Prashant Ved

(Edited)

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Concluded answer
It's an epidermoid tumor.. needs very articulate surgery.. cranial base exposure.. rt retromastoid..superior component may need second surgery from subtemporal route or combined approach
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Irregular lobulated extra-axial lesion Rt Cp angle ,rtperi/ prepontine cistern, compressing the adjacent structures,T1 hypointense,T2 hyperintense,hyperintense on DW1 . Possible epidermoid cyst. Ref to Neurosurgeon. Surgery is the treatment
Thank u ma'am its an epidermoid cyst as per my DX as well and the case is now referred to nsx
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Onset? Duration of illness ?? DWI appears hyperuntensity but corresponding ADC is not hypo.. Again T2 is hyperintense with T1 hypointens involving brainstem.. Possibility of demyelination, 2nd mitotic , 3rd stroke of more than 10 days
Thank you @Dr. Anand Kumar I forgot to write onset and duration of the illness (have edited the question too) 1. Onset : present at the time of walking 2. Duration >1 year now
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It's an epidermoid tumor.. needs very articulate surgery.. cranial base exposure.. rt retromastoid..superior component may need second surgery from subtemporal route or combined approach
Thank you sir that was my dx also...
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