PMC8492439_01
Preoperative sellar MRI and CT scan. (a) MRI - T1-weighted sagittal slice demonstrating hypointense cystic lesion in sellar space. (b) MRI - T2-weighted coronal slice demonstrating hyperintense lesion (c) CT sagittal slice demonstrating sellar type of sphenoid sinus.
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F1
Preoperative sellar computed tomography (CT) and magnetic resonance imaging (MRI) scan revealed a cystic sellar lesion [Figure 1a-c].
Postoperative sellar MRI and CT scan. (a) MRI - T2-weighted sagittal slice demonstrating empty sellar space after Rathke's cleft cyst gross total resection and nasoseptal flap closure. (b) CT sagittal slice shows minimum pneumoencephalon in sellar region after endoscopic procedure (c) Bone window CT sagittal slice - demonstrating absence of bone coverage on sellar floor.
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F2
Postoperative sellar MRI confirmed total resection [Figure 2a-c].
Cervicothoracic MRI. (a) T2-weighted sagittal slice demonstrating hyperintense lesion inside D3-D4 spinal cord. (b) T2-weighted axial slice shows an assymetric hyperintense lesion (right side) pushing spinal contents.
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T3-T4 intramedullary lesion. The lesion was hyperintense on T2 and most notably in the right side of the spinal cord on the axial plane [Figure 3a and b].
Spinal dural arteriovenous fistula (SDAVF) microsurgery. (a) After dural opening, an important medullary hematoma associated with SDAVF was identified. (b) After blood aspiration, the SDAVF became more evident. (c) The spinal hematoma was aspirated (asterix). After identification of the right T3 artery feeder and venous portion, the shunt was coagulated and cut.
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An emergency thoracic laminectomy (T2-T5) was performed [Figure 4a-c].
Head CT performed 10 days after SDAVF microsurgery. (a-d) Axial slices demonstrating diffuse white matter hypointensity due to hypoxic encephalopathy.
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The brain CT demonstrated a diffuse white matter hypodensity [Figure 5a-d].