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A 30yrs old male presented to ER with H/o stabbing right TemporoParietal headache since a year associated with dizziness.At the time of presentation patient had multiple episode of convulsive seizures. O/e - Semiconscious, disoriented,No focal neurological deficit,Pupils - Left 4mm RTL,Right 6mm SRTL,GCS - 11/15. DIAGNOSIS AND APPROACH??

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NCCT Shows mildly hyperdense RT temporal abteromedial with significant perilesion edema with mild compression of rt lateral ventricleT1 contest shows cauliflower like growth well enhancing by contrast Rt planum sphenoidal mass projecting to rt temporal area with perilesion edema Meningioma arising from plenum sphenoidale

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Right TP SOL with mass effect.. Obstructive hydrocephalus. D/d meningioma.? Glioblastoma? Cerebral abscess? Ad- Neuro surgery icu care with mechanical ventilation. -ICP Controll measures,,, IV manitol,, IV antiepileptics,,, IV dexamethasone,,, IV broad spectrum antibiotics.. -Neuro surgical intervention

A right temporal space occupying lesion with perilesional oedema with slight compression of right lateral ventricle seen in NCCT brain which on MRI scan is well enhanced by contrast . Most likely Astrocytoma. A biopsy is needed to proceed further for surgery to assess grade of tumour or glioblastoma multiforme which is an aggressive malignancy with poor prognosis

NCCT Shows mildly hyperdense RT temporal abteromedial with significant perilesion edema with mild compression of rt lateral ventricleT1 contest shows cauliflower like growth well enhancing by contrast Rt planum sphenoidal mass projecting to rt temporal area with perilesion edema Meningioma arising from plenum sphenoidale

Rt temporal space occupying lesion with mass effect, with anteriorly contrast enhancement Needs mrs and biopsy Possibility of astrocytoma, or other glioma.. Discussion for neurosurgeons and radiotherapy team Anti epileptics and conservative measure till than Prognosis depends on grade of lesion

@Dr. Anand Kumar @Dr. Jaideep Chandra @Dr. Padam Chand @Dr. Manorama Rajan @Dr. Parveen Yograj sir

Rt tp sol with dco .needs surgery

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