Neuroradiology

Dr. Rakesh
Neurosurgery resident,
Svims,tirupati
A 40/M patient with no co-morbidities presented
with

-c/o headache, holocranial type, since 5 months,

associated with nausea aggrevated in last 1 week
- c/o seizures (generalized tonic clonic).
-no h/o vomiting
-no c/o fever
-no h/o trauma
O/E:patient conscious,
Vitals stable
GCS-E4V5M6

-CNS examination
Higher mental function
• normal
Cranial nerve examination
• CN 1: B/L sense of smell normal

• CN2: VA right –6/6 and left – 6/6

fundoscopy –normal disc

CN 3,4,6-
• EOM normal
• No ptosis
• Pupils- B/L 3mm equal and reactive.
• Other - normal
MOTOR SYSTEM:

Tone

• Normal in both upper and lower limbs

Bulk

• Normal in both upper and lower limbs

Power- 5/5 all limbs
Reflexes –
DTR: 2+ all
Planter –both flexors
Sensory system-normal

Cerebellar signs: absent

Tandem Gait : normal

Meningeal signs: no
• CT Brain-
• MRI brain-
• MR Specroscopy-
Differential diagnosis
• Oligodendroglioma (ODG)
• Astrocytoma
• Glioblastoma
• Meningioma
• Underwent left frontal craniotomy and gross total
excision of tumor through interhemispheric
approach.
• Biopsy – oligodendroglioma WHO grade 2
Thank you