PMC3669471_01
(a) Preoperative T1 weighted sagittal MRI showing panventriculomegaly with communication of the fourth ventricle with the holocord syrinx, (b) Preoperative T2 weighted sagittal MRI showing panventriculomegaly with communicating syringomyelia, (c) Postoperative CT scan after ventriculoperitoneal shunting showing decompression of the lateral ventricles with disproportionate dilatation of the fourth ventricle
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F1
There was evidence of communication of fourth ventricle with the syrinx [Figure 1a and b]. CT scan showed decompression of the supratentorial ventricles with persistent dilatation of the fourth ventricle [Figure 1c] and hence, the patient underwent foramen magnum decompression and intradural exploration.
Postoperative sagittal T1 weighted (left panel) and T2 weighted (right panel) MRI showing significant reduction in the size of the ventricles and syrinx; arrow points to the persistent central canal
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F2
However, interestingly, a thin streak of CSF representing the central canal was found extending from upper cervical to lower thoracic regions [Figures 2 and 3].
Postoperative sagittal T2 weighted MRI of the thoracolumbar region showing the persistent central canal (arrow)
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F3
However, interestingly, a thin streak of CSF representing the central canal was found extending from upper cervical to lower thoracic regions [Figures 2 and 3].
(a) Sagittal T1 weighted MRI at the time of shunt dysfunction showing panventriculomegaly with holocord syrinx, (b) Sagittal T2 weighted MRI at the time of shunt dysfunction showing panventriculomegaly with holocord syrinx
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F4
MRI at this time revealed pan ventricular hydrocephalus with the fourth ventricle communicating with the holocord syrinx [Figure 4a and b].