• 20+ year old man with headache, nausea and vomitting.
  
  
• On examination he had no focal neurological deficit and was completely alert and oriented.

• MRI scan of patient’s brain shows a tumor within the 4th ventricle impinging on brainstem and mild hydrocephalus.

• Stereotaxy and computer navigation was utilized to localize and remove the tumor precisely, with surrounding neuro-vascular structures mapped out and protected.
• Sub-occipital inter-tonsillar approach was utilized.

• The pathology of the tumor confirmed diagnosis of medulloblastoma.

Before Operation                                          After Operation

• Post op MRI shows complete resection of the tumor with no injury to surrounding neuro-vascular structures and resolution of hydrocephalus.

Before Operation                                          After Operation

• Post op MRI shows complete resection of the tumor with no injury to surrounding neuro-vascular structures and resolution of hydrocephalus.

• The patient did well post-operatively with no neurological deficit. He was discharged home and returned to full employment.