Hemangioblastoma

Dr. Samuel Oluka

 CT

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 Conclusion
 A large cystic lesion in the left cerebellar hemisphere
 The 4th ventricle is effaced and displaced to the right, there's dilatation of
the 3rd and lateral ventricles
 With resultant
 Effacement of the basal cisterns( prepontine, CP angle cisterns,
suprasellar and interpeduncular and quadrigeminal cisterns) are effaced
 With periventricular CSF seepage
Ddx
Hemangioblastoma
Pilocytic astrocytoma
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 MRI

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 MRI

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 Mri conclusion

 T1, hypointense, T2 hyper intense and Flair partially nulling well

circumscribed cystic lesion in the left cerebellar hemisphere, causing
effacement and rightward displacement of the 4th ventricle with resultant
hydrocephalus.
 Post-contrast- avidly enhancing eccentrically located mural nodule, the
rest of walls do not enhance
 Ddx hemangioblastoma

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 Intraoperative notes and findings
 Positioned prone on 3 point fixation, aseptically,
 Identified fraziers point on the right side, 100mls of clear CSF drained,
 Hockey stick skin incisions made on the left side opening done in layers,
asterion identified and burr hole made over it
 Left suboccipital craniotomy done and bone flap elevated
 Dura opened in a cruciate manner
 Aspiration of the fluid within the cystic capsule done
 Circumferential dissection of the mural nodule done and removal done in
total

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  Hemostasis achieved,
 Dural closed in a water tight fashion
 Bone flap replaced and secured
 Wound closure done in layers
 Evd closed
 Admitted to ICU

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 Post-Operative scan

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 Pre-op vs post-operative

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 Post operative CT scan

 Cystic area in the left cerebellar hemisphere, with an overlying previous

craniotomy site, the 4th ventricle is well demonstrated and in the midline,
the prepontine and basal cisterns are also well demonstrated. Has
ventriculomegaly, but with no features of hydrocephalus.
 Imp:
 post operative changes with resolved hydrocephalus

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 Current clinical status

 Low vision patient; attending occupational therapy and low vision

navigation

 Preoperative symptoms, headache, reduced activity have all resolved.

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