This month we would like to share a case of a 52-year-old gentleman who presented with severe headache, tingling and numbness over the right half of the body. He was evaluated with an MRI of the Brain which showed an Extra axial heterogenously enhancing lesion in the left parietal region. The dimensions of the lesion were 4.5x4.1x3.8 cms (ApxCCxTr) and had a broad attachment with the adjacent dura. It was compressing the adjacent brain parenchyma.
We operated on him under General Anesthesia, a left Parietal Craniotomy was done and the dura overlying the tumor was gently laid open and dissected away from the tumor. To our surprise, on the table the tumor was highly vascular had no clear margins contradicting the MRI findings. So our anaesthesia team started a blood transfusion and the surgical team gradually moved to a piecemeal approach and excised the tumor. A near total excision was achieved and the cavity was packed with hemostatic agents as there was profuse bleeding towards the end of dissection.
We were able to achieve hemostasis and dural reconstruction was done with G Patch. The overlying dura was excised and sent for biopsy alongside the tissue.
The excised tumor tissue and the dura. Dura reconstructed with a G Patch
Post Operative CT Brain showed no gross hematoma and the cavity was suggestive of good resection of the tumor.
