PMC4533470_01
Ophthalmological examinations before the surgery. Ophthalmological examinations revealed right-sided paresis of the abducens nerve.
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F1
Ophthalmological examinations revealed right-sided paresis of the abducens nerve (Fig. 1), normal corneal reflex, clear cornea and lens, and isochoric pupil reflex.
Preoperative magnetic resonance imaging (MRI) images. Preoperative axial T1-weighted (A), axial T2-weighted (B) and coronal (C), diffusion-weighted (D) and enhanced T1-weighted MRI showed the lesion which had the same intensity as the surrounding subarachnoid space. The cyst wall was not enhanced. Heavy T2-weighted imaging (F) showed the pathway (arrow) of the cerebral fluid from pre-pontine cistern to the cyst.
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F2
Operative view. A: Intradural observation of the anterior aspect of the temporal fossa. 1: temporal bone, 2: lateral wall of the cavernous sinus, 3: dura of temporal lobe. B: The cyst wall was fenestrated. The abducens nerve (arrowhead) was detected in the cyst cavity. 4: Maxillary nerve (V2) at the lateral wall of the cavernous sinus.
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F3
High-pressure, clear and colorless fluid was drained and the abducens nerve was detected in the cyst cavity (Fig. 3).
Computer tomography after the surgery. It revealed that the cyst size was reduced.
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F4
On the follow up CT scan, the size of the cyst was found to be reduced (Fig. 4) and the abducens palsy disappeared (Fig. 5).