PMC9633091_01
Axial and coronal views of preoperative CT scan. These showed tight high convexity CSF spaces, ventriculomegaly, and enlarged Sylvian fissures that suggested disproportionately enlarged subarachnoid space hydrocephalus.
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Computed tomography (CT) scan showed tight high convexity cerebrospinal fluid (CSF) spaces, ventriculomegaly, and enlarged Sylvian fissures that suggested disproportionately enlarged subarachnoid space hydrocephalus (Fig. 1).
Image findings related to TP due to congenital bone defects.
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A) CT scan revealed significant air accumulation observed in the lateral ventricles and subarachnoid space.
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B) MRI revealed a temporal porencephalic cyst extended to the inferior horn of the right ventricle.
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C) Postoperative thin-slice CT scan showed a part of the air cell (red arrow) at the right petrous bone (coronal view).
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D) Preoperative thin-slice CT revealed a small encephalocele through the petrous bone defects (red arrow).
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CT scan and MRI showed significant air accumulation in the lateral ventricles and subarachnoid space and a right temporal porencephalic cyst that extended to the inferior horn of the right ventricle (Fig. 2A, B). A bone window setting of high-resolution CT scan showed that a part of the air cell at the right petrous bone was opened into the subdural space (Fig. 2C). Retrospectively, preoperative CT showed a finding of suspected small encephalocele through the petrous bone defects (Fig. 2D).
Axial view of CT scan after TP improvement.
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No intracranial air was detected in the follow-up CT scan 3 months after readmission (Fig. 3), and his gait and cognitive disorder improved with the shunt pressure setting 7.