J Korean Neurosurg Soc.  1975 Jun;4(1):93-96.

Huge Cystic Cerebellar Astrocytoma of Adult

• Yoo YR
• Chung HY

Abstract

A 48-year-old male patient is presented in whom huge cystic cerebellar astrocytoma simulated cerebellopontine angle tumor. Surprisingly enough, the symptoms started only 20 days prior to admission and expired before opening the dura. The neurological manifestations were of throbbing suboccipital headache, right hemiparesis, slurred speech and ataxia associated with acute increased intracranial pressure. The vertebral angiogram revealed downwardly displaced inferior posterior cerebellar artery without tumor blush. There was no evidence of increased uptake of radioactive isotope in brain scan. Suboccipital craniectomy and total laminectomy of the first and second cervical spine was performed but intradural manipulation was postponed because of tensely bulged dura, excessive bleeding and unstable vital signs to tolerate general anesthesia. The patient died of respiratory arrest 5 hours after the operation. The huge size of cystic astrocytoma on the right cerebellar hemisphere and tremendous cerebellomedullary herniation were found at the time of postmortem examination. Various pathophysiological mechanism which caused this unusual regrettable clinical outcome are briefly considered.

MeSH Terms

Adult*
Anesthesia, General
Arteries
Astrocytoma*
Ataxia
Autopsy
Brain
Headache
Hemorrhage
Humans
Intracranial Pressure
Laminectomy
Male
Middle Aged
Neurologic Manifestations
Neuroma, Acoustic
Paresis
Spine
Transcutaneous Electric Nerve Stimulation
Vital Signs