PMC6778325_01
Sagittal computed tomography image of the brain demonstrates a posterior fossa anomaly with vermian hypoplasia, expansile arachnoid cyst, and hydrocephalus.
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F1
Accordingly, the patient was diagnosed with Dandy-Walker malformation [Figure 1].
(a) Maximum intensity projections of computed tomography (CT) angiography demonstrate stenosis of the basilar artery and aplasia of the right common carotid artery. (b) Multiplanar reconstruction of CT angiography of the neck demonstrates aplasia of the right internal carotid artery. (c) Skull base CT scanning demonstrates an absence of the right carotid canal. (d) Abnormal origin and course of the left subclavian vessels are demonstrated. Bilateral common carotid arteries have arisen from the distal side of the left subclavian artery.
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F2
Cerebral aneurysm was seen in the terminal portion of the left ICA [Figure 2a]. There was a complete absence of the right ICA from the origin with corresponding absence of the left bony carotid canal [Figures 2b and c]. The right subclavian artery had an aberrant course, with its proximal portion making a U-shaped bend [Figure 2d].
(a) Single-photon emission computed tomography demonstrates reduced cerebral blood flow in the border zones between the middle and posterior cerebral artery territories in the right hemisphere. (b) After extracranial-intracranial bypass, cerebral blood flow of the right hemisphere improves to the normal level.
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F3
Single-photon emission computed tomography (SPECT) demonstrated reduced cerebral blood flow (CBF) in the border zones between the middle and posterior cerebral artery territories of the right hemisphere [Figure 3a]. CBF of the right hemisphere was improved to normal level [Figure 3b].