 I am Dr. Jaskaran Singh, consultant neurosurgeon with Manipal Hospital, Patiala. Today I have come here to present a case of brain tumor. The management of brain tumors is pretty difficult and there are a lot of misconceptions about management of brain tumors. So I want to show you a patient who has been managed at Manipal hospitals and the way we were able to manage the patient and how he was treated. I just want to show you the scans and the operative pictures and post-operative findings of the patient. So here is a patient, a 46-year-old male patient presented to us in the emergency with history of seizures. Seizures in which the emergency was controlled, then a CT scan was done. CT scan of the brain which showed that there was a mass or a tumor in the left frontal region of the brain. After that an MRI was done to further delineate the pathology. So MRI we are showing you the picture of the MRI over here. This is a pre-operative that is before the surgery, the picture is showing that there is a large tumor in the left frontal region of the patient. So you can clearly see the tumor, it is marked also. So that is the part where the tumor is in the brain and later on the patient was counseled regarding the treatment options and for brain tumors the first and foremost option is surgery for most of the brain tumors if it is possible. So in this case surgery was clearly the best option and we opted for surgery, we counseled the patient and he gave consent for surgery. So patient was operated when he was stable, the patient was a 46 year old male patient and he underwent a left frontal craniotomy and tumor excision under the microscope. So this is the picture of the patient showing the pre-operative planning. You can see that the tumor has been marked over the area and the incision which is to be given in the left frontal region is marked. After this the patient underwent left frontal craniotomy and with help of a microscope. Microscope is a machine which magnifies the tissues which we are operating upon. So with use of microscope we can clearly see the region of the tumor, we can delineate the tumor and we can make out which part is normal brain and which part is the brain which is involved with the tumor. The microscope helps a lot in this surgery and with microscope we were able to delineate the tumor and the tumor was excised. This is a picture which is showing the tumor excision has been accomplished. You can see the tumor has been removed and the normal brain is left behind and this another picture after this is showing you the various markings which is clearly showing the residual normal frontal lobe which has been left behind after excision of the tumor. Complete excision of the tumor was achieved intraoperatively. Patient was operated under general anesthesia and after closure the patient was shifted to the ICU for one day and he was observed over there. This is the post-operative and pre-operative CT scan of the patient which is being compared side by side. So you can clearly see there is tumor on the left hand side the tumor is there and on the right hand side is the post-operative scan. You can make out that there is no tumor on the scan in the post-operative period. So this patient later on the biopsy of the patient came out to be a high grade glioma that is WHO grade 4 glioma. These tumors are very aggressive tumors and they have high chances of recurrence. So the patient was further referred for radiotherapy and chemotherapy which he got from a medical oncologist and after radiotherapy and chemotherapy a follow-up scan was done at 10 months. So you can see the scan which is done at 10 months after the surgery and completion of radiotherapy and chemotherapy there is no recurrence of the tumor. There is no tumor in this MRI. The patient is completely tumor free and patient is presently working as a teacher. He is doing very well and he hasn't got any residual deficits and he is carrying out his normal activities without any problem. So this is a case simply to let the people know that treatment for brain tumors is very much possible provided that it is done at the right time. So if ever a patient is having any patient who is having adult onset seizures, adult onset seizures means after 30-40 years of age suddenly Dora Pandamirgida, an MRI or CT scan to rule out a brain tumor if a brain tumor is found then depending on the type of the tumor treatment should be given. If surgery is an option then surgery provides very good cure in selected cases and it should be done. So surgery is not a need for any fear or any fear because surgery is a safe option and it gives complete cure to the patients in many cases. Thank you.