PMC6778334_01
(a and b) Preoperative magnetic resonance imaging. The sagittal and axial section on T2-weighted image showing a large cyst with an intensity similar to the cerebrospinal fluid in the posterior fossa with severe compression of the cerebellum and brainstem.
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F1
T2-weighted signals were similar to the cerebrospinal fluid (CSF). The cyst was located in the foramen of Magendie. There was significant compression of the brainstem anteriorly, and the cerebellum was displaced superiorly [Figure 1a and b].
Intraoperative microscopic view. (a) The appearance of the cyst wall after dura mater opening. (b) Brainstem posterior surface after cyst wall removal.
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F2
The dura mater closure was done with autologous graft, then multiple layers closure [Figure 2a and b].
(a and b) The anatomopathological examination with hematoxylin and eosin showed loose fibrous wall cyst lined by flattened meningothelial cells.
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F3
(a and b) Postoperative magnetic resonance imaging. Sagittal and axial section of on T2-weighted image revealing the reduction of the cyst size and a significant decrease in the compression on the brainstem and cerebellum.
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F4
Postoperative imaging showed a significant decrease in the compressive effect on the brainstem and cerebellum [Figure 4a and b].