2. Definition
Brain tumour located outside the brain tissue,
either in the subarachnoid space or arising from
the meninges
External to Pia matter(meninges, nerve sheath)
4. Radiologically recognized by their specific
appearance
Often being surrounded by CSF
Enlarging the subarachnoid space or cistern in which
they are located
Having broadbased attachments to the dura or bone
Compress the adjacent brain without infiltrating it
5. They should be differentiated from an exophytic
growth of intra-axial tumors
In children, extra-axial tumors are much rarer
than intra-axial, particularly in the posterior
fossa.
6. Symptoms & Diagnosis
Increased intracranial pressure
Hemispheric /lobar dysfucntion
Endocrinologic dysfunction
Cranial nerve dysfunction
Symptoms will vary depending on the tumor's
location, size and rate of growth
Brain tumors can mimics other neurological
disorders.
8. MRI without & with IV contrast
CT Scan without & with IV contrast
PET Scan can be used
To see the difference between scar tissue, recurring
tumor cells, and radiation necrosis
Biopsy
The most accurate method of diagnosis
Can be open or close
9. A 45 yr old female presented with headache for
2 years , vomiting off and on , recent onset
memory disturbance & occasional behavioral
disturbance.
On examination patient is conscious and frontal
lobar function were impaired & have bilateral
anosmia
Diagnosis??????
12. A change in behavior:
The development of an "I don't care" attitude
Memory loss & loss of concentration
General confusion
Infertility or amenorrhea
A seizure with ICH that results from a fall may
actually be caused by tumors
13. Patient was planned for elective tumor removal
via anterior skull base approach
Postoperatively patient developed CSF
rhinorrhea
How you will manage
How you would avoid this complication
14. A 69-year-old male presenting with headache
nausea , vomiting , Seizures , vision changes
diplopia and loss of sense of smell
17. Craniotomy and excision
Histopathology confirmed diagnosis as
meningioma
18. 48 year female presented with headaches off and
on 3 years and seizure since 4 months. she
gradually developed Rt sided hemiparesis and
had papilledema
Diagnosis??????
19.
20.
21. Post-op patient recovered well but after 6 hours
patients deteriorated and his GCS was 10/15
with unequal pupils
What would be the reason for this deterioration
How you will manage and prevent this
22. Possible factors
1. Haematoma
2. Edema
3.Infarct
How you will manage
ABC
CT Scan plain
Treatment of the cause
23. 34 year old male presented with headaches,
vomitting dysphaisa, sizures ,diplopia and right
sided weakness. He was also having papilledema
Diagnosis????
24.
25.
26.
27. what would be the Surgical approach
complications
28. 26 year old female presented with headache and
vomiting. she gradually developed left sided foot
drop
Diagnosis ?????
33. Patient underwent craniotomy and excision of
tumor
Patient recovery from anesthesia was uneventful
and shifted to ward
After three days patient gradually became
drowsy and started having vomiting
34. What would be the reason for her deterioration
and how will you manage and avoid such
complications
36. 30 year female presented with progressive
hearing loss for the last 6 years, headaches ,
vomiting & vertigo for the last 3 months.
she has nasal regurgitation. Now she is unable to
walk without support because of poor balance
and eye sight .
Diagnosis?????
43. She has undergone retromastoid craniectomy
and excision of tumor after that she has not
woken up.
1.what is gone wrong with her?
2.how would you manage her ?
44. What has gone wrong
Brain stem injury
Acute hydrocephalus
Clot in the tumor bed
Overdosage of anesthetic gases
45. How would you manage
ABC
CT scan plain
Manage accordingly
How you can avoid such complications
Pre-op planning
Surgical technique
Vigilant post-op monitoring
46. A 41-year-old presented with dizziness and
progressive hearing loss in the right ear,
Decreased right corneal reflex
Right facial nerve palsy
Diagnosis?
49. Schwanoma resected via right Suboccipital
approach.
Postoperatively, she had complete right facial
paralysis.
How you can manage and prevent this
complication
50. 30 year male presented with hoarsness 4
months , Regurgitation 3 months, Headache 1
½ months, Vertigo 1 ½ months, Decreased
hearing left ear
Diagnosis ??
51.
52.
53.
54. Tumor excised via suboccipital craniectomy
Postoperatively patient had difficulty in
swallowing with regurgitaion
How you will manage this patient
55. 33 year female presented with headache,
vomiting and truncal ataxia with verticle
nystagmus and papilledema
56.
57.
58.
59. Arcahnoid cyst excised via suboccipital
craniectomy
What are the postop complications
What are other treatment options
