Chief Complains and Clinical Findings

  • Persistant head ache , neck pain and stiffness over the entire body and electric shock like sensation over the body around the last six months. clinically found to have UMN type of quadriplegia.Her planter were bilateral and upgoing and there was sensory impairment in the form of diminished pin prick sensation around C3 C4 level and there was nystagmus in all direction.


  • CT scan of the brain (Plain & contrast) including C1-C2 revealed that large multilobulated uniformly hyperdense SOL in Cervico-medulary region occupying posterior fossa as well as upper Cervical canal & causing mass effect with mild obstructive hydrocephalus ? Meningioma.
  • MRI scan of brain (Plain & Contrast) gave the impression of a Midline posterior fossa SOL arising from the vermis showing Central mixed intense fluid with an acentric nodule with mass effect is suggesting the possibility of a?Haemangioblastoma
    ? Pilocytic Asterocytoma
    Post operative Histopathology suggested a epidermoid cyst


  • The patient was managed surgically.The treatment modality was:- Sub-occipital midline post fossa Craniotomy & C1 posterior arch removed
    + near total removal of SOL done with the help of microscope.
  • The lesion was well delineated thick capsule with intrinsic greenish solid mass along with gel like substance. The lesion was attached to the brain stem.


  • Sections show a cyst containing eosinophilic proteinacious material and wall shows keratin flakes. Features are consistent with epidermoid cyst

Pre Operative Images

Post Operative Images