Midline posterior fossa lesion in an adult male


A middle aged male presented with symptoms of raised intracranial pressure and gait ataxia. He had bilateral papilloedema and bilateral cerebellar signs. Above pictures are of postcontrast CT scan head. A right ventriculoperitoneal shunt was done 5 days back and today posterior fossa midline craniotomy was done. What do you think is the diagnosis? Are you satisfied with CT pictures only or will you do a MRI also? I did nothing more  and operated him based on these images because I thought that CT head was enough to make a decision of doing surgery, and therefore saved some money of the patient.

A midline posterior fossa craniotomy and total excision of epidermoid was done.

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written by sharmakchand, March 30, 2014
I have edited the blog. Patient has titubations in postop period.
written by sharmakchand, March 31, 2014
https://www.youtube.com/watch?v=T9obirLmDVs-- This is URL of video of same patient

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