PMC5767483_01
(a-c) Preoperative 3-dimensional CT revealed the absence of a sagittal suture but no scaphocephaly. (d-f) Preoperative CT showed protrusion of the posterior rim of the foramen magnum and a tight foramen magnum.
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F1
The foramen magnum was stenosed due to a protruding posterior rim (Fig. 1).
Preoperative MRI showed tonsillar herniation to the foramen magnum, CM-1 (a), and holocord syringomyelia (b, c). Cerebral angiography showed occlusion of the right transverse to the sigmoid sinus at the venous phase, and that the bilateral occipital sinuses were the main source of blood flow to the extracranial lesions (d).
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F2
However, the CSF space around the foramen magnum was too narrow to open the sulci (Fig. 2a). CM-1 and holocord syringomyelia (Figs. 2b and 2c). Cerebral angiography showed occlusion of the right transverse to the sigmoid sinus at the venous phase, and that the bilateral occipital sinuses were the main source of blood flow to the extracranial lesions (Fig. 2d).
(a-c) Postoperative CT showed successful decompression of the foramen magnum and open CSF space from behind the cerebellar tonsil to the medulla.
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F3
The foramen magnum was successfully decompressed, and the size of the syringomyelia decreased (Figs. 3 and 4).
Postoperative MRIs: 3 months after surgery, the syringomyelia had decreased in size (a, b), it was even smaller 2 years after surgery (c, d).
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F4
The foramen magnum was successfully decompressed, and the size of the syringomyelia decreased (Figs. 3 and 4).