A 74 year old lady presented with progressive depression. She had been treated medically for months but her symptoms did not improve. She then developed headaches and cognitive deficits such as poor short term memory became increasingly obvious.
An MRI scan of the brain was eventually done, revealing a very large lesion of the anterior cranial fossa. Surgery proceeded on a semi-urgent basis, given the degree of mass effect from the tumour.
A coronal incision was made and a bifrontal craniotomy performed. The tumour was moderately vascular, but a complete resection was achieved, without damage to nearby important structures, such as the optic nerves/chiasm/tracts, or the anterior cerebral arteries and branches.
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