PMC4323511_01
A : Preoperative sagittal T2W TSE MRI showing turbulent flow of CSF in the fourth ventricle and back flow of CSF through the Monro's foramen to the lateral ventricles. B : Preoperative axial T2 MRI showing significant dilatation of fourth ventricle with turbulent flow of CSF. C : Preoperative axial T1 MRI showing dilatation of third, fourth and lateral ventricles. D : Preoperative axial T1 MRI showing significant dilatation of fourth ventricle. CSF : cerebelospinal fluid.
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F1
T2W TSE study was also performed and demonstrated a turbulent flow of cerebelospinal fluid (CSF) in the fourth ventricle and back flow of CSF through the Monro's foramen to the lateral ventricles (Fig. 1). The patient had also undergone fundoscopic examination that showed bilateral papilledema.
A : Perioperative photo showing the occlusion of Magendie's foramen by the membrane. B : Perioperative photo showing Magendie's foramen after the incision and removal of the membrane.
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F2
An occlusion of Magendie's foramen by a thickened membrane was recognized and the membrane was incised and removed, thus restoring the normal flow of cerebrospinal fluid between the fourth ventricle and the cerebellomedullary cistern (Fig. 2).
A : Postoperative sagittal T1 MRI showing marked decrease in the size of the ventricles. B : Postoperative coronal T1 MRI showing marked decrease in the size of the ventricles. C : Postoperative axial T1 MRI showing marked decrease in the size of the ventricles.
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F3
The new fundoscopic examination in two weeks revealed a reduction in papilledema and the second MRI scan showed a marked decrease in the size of the ventricles, showing therefore that cerebrospinal fluid flow through the ventricular system and subarachnoid space was restored (Fig. 3).