case_images: PMC11811082_01
case_images: Preoperative imaging examination, intraoperative findings, and postoperative follow-up of the patient in Case 1. (A-F): CT and MRI reveal multiple intracranial masses and clear signs of obstructive hydrocephalus. (G): CCM obstructing the cerebral aqueduct with surrounding hemosiderin deposition. (H): After balloon catheter puncture and fistula creation, the fistula was patent, and the basilar artery showed good pulsation. (I-K): MRI results on the third day postoperatively. (L-N): MRI results at the third-month postoperative follow-up.
case_images: fonc-15-1513254-g001.jpg
case_images: PMC11811082_02_fonc-15-1513254-g001.jpg
case_images: f1
case_images: Imaging results were consistent with expectations ( Supplementary Figure S1 ).
case_images: PMC11811082_02
case_images: Preoperative imaging examination, intraoperative findings, and postoperative follow-up of the patient in Case 1. (A-F): CT and MRI reveal multiple intracranial masses and clear signs of obstructive hydrocephalus. (G): CCM obstructing the cerebral aqueduct with surrounding hemosiderin deposition. (H): After balloon catheter puncture and fistula creation, the fistula was patent, and the basilar artery showed good pulsation. (I-K): MRI results on the third day postoperatively. (L-N): MRI results at the third-month postoperative follow-up.
case_images: fonc-15-1513254-g001.jpg
case_images: PMC11811082_02_fonc-15-1513254-g001.jpg
case_images: f1
case_images: Imaging results were consistent with expectations ( Supplementary Figure S1 ).
case_images: Preoperative imaging examination, intraoperative findings, and postoperative follow-up of the patient in Case 2. (A-E): CT and MRI reveal a mass in the midbrain and clear signs of obstructive hydrocephalus. (F): CCM obstructing the cerebral aqueduct with surrounding hemosiderin deposition. (G-H): Select the appropriate site and create the fistula. (I-L): MRI results on the seventh day postoperatively.
case_images: fonc-15-1513254-g002.jpg
case_images: PMC11811082_02_fonc-15-1513254-g002.jpg
case_images: f2
case_images: CT scans ( Figure 2A ) showed bilateral ventricular enlargement with a mixed-density mass in the brainstem obstructing the midbrain aqueduct. MRI ( Figures 2B-E ) revealed shallow supratentorial sulci and cisterns, ventricular enlargement, downward displacement of the third ventricle floor, and a mixed signal mass in the brainstem, with localized narrowing and obstruction of the midbrain aqueduct, consistent with obstructive hydrocephalus. Intraoperative findings ( Figures 2F-H ) were consistent with hydrocephalus, showing ventricular enlargement and downward displacement of the third ventricle. Follow-up MRI on postoperative day 7 ( Figures 2I-L ) showed improved ventricular enlargement, with deepened sulci and cisterns and reduced interstitial edema compared to preoperative imaging.