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all10377_fm - SNAPSHOT Giant occipital intracranial and...

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A 17- YEAR - OLD MAN presented with a history of several months of constant, throbbing headaches. He had always had long hair, concealing an obvious skull deformity that had not previously been noticed. Examination revealed a visible occip- ital deformity of the skull (Box, A). He had chronic papilloedema, with a vis- ual acuity of 6/60 within markedly contracted visual fields. There were no other neurological abnormalities. Imaging X-rays, computed tomography and magnetic resonance imaging further delineated the anatomy of the lesion (Box, B,C). Volume estimation 1 yielded a total volume of 1094 cm 3 , making this one of the largest meningi- omas ever reported. Management The patient was given high-dose corti- costeroids, and surgical excision was undertaken in two stages. At the first operation, the extracranial component and most of the hyperostotic bone were removed (Box, D). A week later, the remainder of the tumour was removed and the involved (and occluded) supe- rior sagittal sinus resected. The post-
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  • Spring '09
  • 123456
  • Cerebrospinal fluid, Neurosurgery, Meningioma, Neurosurgery Westmead Hospital, Department of Neurosurgery † Radiologist

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