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1. NEUROLOGICAL FORMULATION Mr. H . 26 yo , right-handed woman, Javanese, presents with headache worsening progressively since 3 years ago. Since 2 years before admission She complained blurred vision on the right side. T he patient was unable to communicate especially said a word then followed by additional blurred vision on the left side of the eye, slurred speech and asymmetrical lip since 1 year ago. Since 6 months before admission to the hospital, the patient felt weakness on the right side of extremity also hearing loss . On Neurological examination there are Chronic progressive cephalgia, cognitive impairment, Bilateral Hemiparesis UMN Type, Right H emihypesthesia , Bilateral Optic Nerve dysfunction , Right Facial Nerve Palsy UMN Type , Right Hypoglossus Nerve UMN Type , Bilateral SNHL more severe in the right side These findings are consistent with a Space Occupying Lesion in the Left F rontotemporoparietal lobe. The most likely diagnosis is a Space O ccupying L esion in the Left F rontotemporoparietal lobe suspect Primary Tumor but Secondary tumor could not be excluded. 1

2. The resume all aspect of diagnosis are Clinical diagnosis   : Chronic progressive cephalgia Cognitive impairment Bilateral Hemiparesis UMN Type R ight H emihypesthesia Bilateral Optic Nerve Dysfunction Right Facial Nerve Palsy UMN Type Right Hypoglossus Nerve UMN Type Bilateral SNHL more severe in the right side Topical diagnosis : Left Frontoparietotemporal lobe Etiological diagnosis : Intracranial Space Occupying Lesion dd/ Primary Brain Tumor dd Secondary Brain Tumor Pathologic diagnosis : On Process Working diagnosis : Intracranial Space Occupying L esion dd/ Primary Brain Tumor dd Secondary Brain Tumor