PMC9596234_01
Simple skull tomography. (a). Infarction in the left cerebellar hemisphere. (b). Collapse of the fourth ventricle and hydrocephalus. (c). Dilation of the third ventricle and lateral ventricles.
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fig1
An emergent simple skull computed tomography (CT) was performed, which indicated cerebellar stroke and obstructing hydrocephalus (Figures 1 and 2).
Angiography of the head and neck vessels. A pseudoaneurysm of the left vertebral artery is observed at the level of C4 with an associated arteriovenous fistula and without signs of active bleeding. The pseudoaneurysm measures 8.5 mm anteroposterior diameter, 7.3 mm transverse diameter, and 8 mm craniocaudal diameter. Hyperdensity of adjacent venous structures is observed, and the venous phase is better visualized after configuring an arteriovenous fistula with a filiform filling of the distal vertebral artery.
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fig2
An emergent simple skull computed tomography (CT) was performed, which indicated cerebellar stroke and obstructing hydrocephalus (Figures 1 and 2).
Panangiography depicting vertebral artery occlusion. The fistula is occluded with five Axium coils and a vial of Squid 12.
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fig3
An emergent head and neck angiotomography indicated a compromise of the vertebral artery with a pseudoaneurysm (Figure 3).
Simple control computed tomography of the skull. (a). Established infarction in the left cerebellar hemisphere. (b). Ventricular and cisternal systems with normal shape, size, and position. (c). A ventricular bypass catheter enters through the right frontal region, with the distal end in the frontal horn of the right lateral ventricle. (d). Decrease in size of the right ventricular system compared with the contralateral side.
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fig4
The patient was then transferred to the intensive care unit.  Figure 4 presents a simple skull control tomography showing the normal shape, size, and position of the ventricular and cisternal systems and a decrease in the size of the right ventricular system compared with the contralateral side.