An extremely concerned young mother brought in her three year old son for assessment. He had developed a staggering gait, deviation of his gaze, and vomiting. On presentation to the Korle-Bu Hospital, Joseph (pseudonym) was found to be alert; however, he exhibited a broad-based unsteady gait with a tendency to fall towards the left side. He also had raised intracranial pressure. A CT brain scan revealed a huge but well-defined tumour in his midbrain.
In November 2002, Joseph underwent surgery and in spite of deficient lighting and a lack of surgical microscope magnification, his surgeons accomplished a gross total excision of his tumour. Joseph's pathology report was significantly delayed and in June 2004, his symptoms returned. A repeat CT scan revealed that his tumour had recurred. A second surgery was seriously delayed by several months due to the lack of a ventilator needed for such a procedure. In spite of a second surgery in August 2004 to remove this extensive re-growth, Joseph tragically died a month later.
