PMC6194733_01
T1 weighted post contrast magnetic resonance imaging depicting the destructive nature and invasion of the vascular lesion; although it is closely associated with dura and superior saggital sinus, there is no evidence of parenchymal invasion. Digital Subtraction Cerebral Angiogram (right sided image) further characterizing the vascular lesion; arterial supply with fistulization from the ophthalmic artery and also some lesser arterial supply from the superficial temporal arteries bilaterally
SNI-9-205-g001.jpg
PMC6194733_01_SNI-9-205-g001.jpg
F1
Heterogenous contrast enhancement on magnetic resonance imaging [Figure 1] further defined the lesional dural involvement and invasion into the superior sagittal sinus sparring cerebral parenchyma.
These images detailing of the preparation and incisional marking. The lesion's sheer size can be appreciated
SNI-9-205-g002.jpg
PMC6194733_01_SNI-9-205-g002.jpg
F2
T-shaped incision followed by bilateral frontal craniectomies [Figure 2].
From Left to Right; Saggital and axial postoperative magnetic resonance imaging sections; H and E stains showing the mixed cavernous and capillary portions of the highly vascular lesion with invasion into bone
SNI-9-205-g003.jpg
PMC6194733_01_SNI-9-205-g003.jpg
F3
A custom-made titanium implant was used for cranioplasty [Figure 3].