Freiburg Neuropathology Case Conference

Abstract

An 89-year-old patient was admitted through our Accident and Emergency department after a domestic fall. Upon neurological examination, the patient appeared somnolent and had a dysarthric speech. A cranial computer tomography (CT, Fig. 1a), as well as subsequent magnetic resonance imaging (MRI, Figs. 2 and 3) of the head revealed a right cerebellar mass. A cranial CT also performed in relation with a domestic fall 3.5 years earlier already showed a small hypodense lesion in the same location (Fig. 1b). Due to the increase in size and the increasing mass effect of the lesion, with compromised cerebrospinal fluid (CSF) outflow, surgery was recommended. The operation was performed with the patient under general anesthesia and in a prone position. After suboccipital craniotomy, access to the tumor was gained. The tumor was found to be hard and very bloody and was removed circumferentially. Despite its proximity to the tentorium, the tumor was located strictly intra-axially.