ABSTRACT
Management is an important feature in the investigation viva. In a viva setting, remember this is a neurosurgical rather than a radiology examination. The most common method in a neurosurgical setting is with an Intracranial pressure monitor. A 46-year-old teacher was admitted to the neurosurgical ward with a onset of cognitive decline and headache. An magnetic resonance imaging brain scan demonstrates a contrast-enhancing solitary lesion adjacent to the occipital horn of the left ventricle. The mass effect and bleed seem to have occluded the right foramen of Monro causing contralateral dilated ventricles. Left-sided cerebellar infarction with obliteration of the fourth ventricle. The patient could develop cerebellar or brainstem infarction and oedema of the posterior fossa structures. This would result in an acute obstructive hydrocephalus. The patient would typically present with severe headache and reducing level of consciousness.
