Patient History

A 28-year-old white female had a cerebellar tumor resected via a posterior craniotomy in 1996.  Because of a recurrence of the tumor with resultant obstructive hydrocephalus, she required ventriculoperitoneal shunt implantation in 1997.  She underwent an additional posterior craniotomy for tumor excision in 2001.  Since that time, she had been observed with yearly MR studies of the brain.  With time, an interval increase in tumor size was noted although the patient remained asymptomatic.  Conservative therapy was employed.  Recently, she presented to an outside hospital with a chief complaint of severe headaches and gait ataxia that began several weeks ago.  A CT scan of the brain revealed a left cerebellar lesion with compression of the fourth ventricle.  She was transferred to our facility for further care.  The patient was placed on high dose steroids and an MR study of the brain was obtained.  She was taken to the operating room for a posterior fossa craniotomy for tumor excision.