case_images: PMC10573303_01
case_images: Preoperative contrast-enhanced CT and MR images of the case exhibiting a large, left-sided pedunculated protrusive diverticulum and ipsilateral distal TS stenosis coupled with contralateral TS hypoplasia. (A) Axial contrast-enhanced CT image demonstrating the protrusion of the pedunculated diverticulum into the subcutaneous tissue (white arrow). (B) Coronal contrast-enhanced CT showing the protrusion of the pedunculated diverticulum into the subcutaneous tissue (white arrow). (C) Volume rendering technique (VRT) of the CT angiography showcasing ipsilateral dominant drainage and contralateral TS hypoplasia. (D) Volume rendering technique of the CT angiography illustrating the location of erosion of the mastoid cortex and diverticular wall protrusion caused by the diverticulum. (E) Coronal contrast-enhanced MR image exhibiting the pedunculated diverticulum and underdeveloped contralateral sigmoid sinus. (F) Axial contrast-enhanced CT slice revealing a significantly smaller internal jugular vein on the left side than on the right side (blue arrows).
case_images: fsurg-10-1268829-g001.jpg
case_images: PMC10573303_01_fsurg-10-1268829-g001.jpg
case_images: F1
case_images: Contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging were performed, revealing a large left-sided SSD, severe ipsilateral distal TS stenosis, and contralateral transverse-sigmoid sinus aplasia (Figures 1, 2).
case_images: Preoperative and postoperative CT and MR images demonstrating TS lumen expansion. (A) Preoperative VRT CT image revealing extrinsic compression of the brain parenchyma (indicated by black arrows). (A) T2 coronal MR image illustrating intrinsic compression of the TS lumen due to arachnoid granulation (AG) invagination. (C) Preoperative maximum intensity projection (MIP) MR venogram image showcasing the TS stenosis in the case (highlighted by blue arrows). (D) Postoperative MIP MR venogram image displaying the enlargement of the TS lumen and the relief of the TS stenosis (indicated by blue triangles). (E) Preoperative VRT image reconstructed using the MR venogram of the ipsilesional transverse-sigmoid sinus without communicating branches (blue arrows). (F) Postoperative VRT image reconstructed using the MR venogram of the ipsilesional transverse-sigmoid sinus without communicating branches (blue triangles). A significant lateral expansion of the postoperative TS lumen can be observed compared to the preoperative condition. (G) Preoperative VRT image reconstructed using the MR venogram of the ipsilesional transverse-sigmoid sinus. (H) Postoperative VRT image reconstructed using the MR venogram of the ipsilesional transverse-sigmoid sinus. Here, a slight difference in the vertical expansion of the postoperative TS lumen can be discerned compared to the preoperative state.
case_images: fsurg-10-1268829-g002.jpg
case_images: PMC10573303_01_fsurg-10-1268829-g002.jpg
case_images: F2
case_images: Contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging were performed, revealing a large left-sided SSD, severe ipsilateral distal TS stenosis, and contralateral transverse-sigmoid sinus aplasia (Figures 1, 2).
case_images: Preoperative and postoperative (2 years) radiologic outcomes of transtemporal TS decompression surgery. (A,B) Corresponding coronal contrast-enhanced CT images showcasing the most significant postoperative expansion of the cross-sectional area of the TS at the distal end of the TS. (C,D) Expansion of the TS lumen at the site of intrinsic and extrinsic compression (indicated by white arrows) following surgical decompression (indicated by yellow arrows). It is noteworthy that the presence of the BB prevents the subcutaneous tissue from collapsing the TS wall. (E,F) Postoperative expansion of the TS lumen after surgical decompression (yellow arrows).
case_images: fsurg-10-1268829-g003.jpg
case_images: PMC10573303_01_fsurg-10-1268829-g003.jpg
case_images: F3
case_images: TS decompression surgery (Figure 3), a Y-shaped incision is required that intersects with the postauricular C-shaped incision.