PMC10159282_01
(a-d) Magnetic resonance image (MRI) showing an enlarged ventricle and cystic formation at the caudal side of the cerebellum. (e) The choroid plexus extends into the cyst compatible diagnosed as Blake's pouch cyst (arrow). Sagittal MRI showing a downward bulging third ventricle floor and membrane like structure within the prepontine cistern (arrowheads). (f and g) Cine phase-contrast MRI revealing a normal bidirectional flow at the level of the aqueduct canal (arrowhead) but not at the prepontine cistern (arrow). (h and i) Intraoperative findings. (h) Scarring in the prepontine cistern (arrowheads) and basilar artery (arrows). (i) After opening the scar, abducens nerve (arrowheads).
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F1
Computed tomography revealed ventriculomegaly (Evans index 0.45), and magnetic resonance imaging (MRI) revealed a cystic formation at the caudal side of the cerebellum, leading to a diagnosis of BPC [Figures 1a-e]. Sagittal MRI results revealed a downward bulging third ventricle floor and membrane-like structure within the prepontine cistern [Figure 1e]. Cine phase-contrast MRI revealed a normal bidirectional flow at the level of the aqueduct canal but none at the prepontine cistern [Figures 1f and g]. We also opened the scarring with perforating forceps under the critical observation of a flexible neuroendoscope [Figures 1h and i].
(a and b) Postoperative magnetic resonance imaging (MRI): (a) The opening of the floor of third ventricle is observed (arrow). (b) The opening of the scarring in the prepontine cistern also observed (arrow). (c and d) Cine phase-contrast MRI indicating the cerebrospinal fluid flow in the prepontine cistern (arrowheads).
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F2
Cine phase-contrast MRI revealed CSF flow in the prepontine cistern [Figure 2].