History & Physical

• 67-year-old man who presented to the emergency room with headache, nausea and vomiting, progressive difficulty with swallowing.
  
  
• On examination, the patient had no focal neurological deficit.
  

MRI scan of the patient’s brain shows a left extra-axial tumor at the cerebellopontine angle region, resulting in obstructive hydrocephalus with effacement of the fourth ventricle and mass effect on brainstem.

• He underwent ventriculostomy followed by retro-sigmoid craniotomy and resection of this tumor utilizing stereotactic and computer navigation, intraoperative neurophysiological monitoring, including brainstem auditory evoked response (BAER), motor evoked potential (MEP), somatosensory evoked response (SSEP), and facial nerve monitoring.

The pathology of the tumor confirmed diagnosis of transitional meningioma.

Post-op MRI shows complete resection of the tumor with no injury to surrounding neurovascular structures.