case_images: PMC9175973_01
case_images: Sagittal (a) and axial (b) T2-weighted magnetic resonance images demonstrating neurovascular conflict on the right side (yellow circle) between the trigeminal nerve and a descending loop of the superior cerebellar artery.
case_images: acmi-4-0335-g001.jpg
case_images: PMC9175973_01_acmi-4-0335-g001.jpg
case_images: F1
case_images: Axial non-contrast computed tomography scans taken (a) 8 weeks post-operatively, showing hydrocephalus, and (b) following insertion of an external ventricular drain into the right lateral ventricle, enabling decompression of the ventricular system.
case_images: acmi-4-0335-g002.jpg
case_images: PMC9175973_01_acmi-4-0335-g002.jpg
case_images: F2
case_images: However, he re-presented 8 weeks post-operatively with new confusion, and a CT head revealed hydrocephalus (Fig. 2a). The following day his conscious level deteriorated and he underwent insertion of an external ventricular drain (Fig. 2b); at operation there was found to be turbid CSF under pressure.
case_images: Vancomycin-resistant 
  
  E. faecium
  
   growing up to and around a vancomycin disc on both Columbia blood agar (a) and Mueller-Hinton (b) agar plates.
case_images: acmi-4-0335-g003.jpg
case_images: PMC9175973_01_acmi-4-0335-g003.jpg
case_images: F3