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Hemangioblastoma is a benign brain tumor which presents with features of raised intracranial pressure in the majority. MRI is characteristic with a brilliantly enhancing module and peritumoral non-enhancing cyst. Whenever there is radiological suggestionof hemangioblastoma, complete neural axis screening shoud be performed as some patients could be having syndrome of von-Hippel Lindau disease.
A 65 year old patient presented with a cerebellar hemangioblastoma. His pre-operative CT (Figure 1) and MRI (Figure 2) showed a lesion in left cerebellar hemisphere with significant mass effect. He underwent placement of external ventricular drain to relieve the hydrocephalus followed by suboccipital craniotomy and gross total tumor excision. Patient tolerated the procdure well and recovered uneventfully. His histopathology was suggestive of hemangioblastoma.
Aids used: Microscope

Figure 1a: Pre-op CT scan with left cerebellar tumor

Figure 1b: Pre-op MRI with left cerebellar tumor

Figure 2: Post-op CT scan with no residual tumor