PMC7332699_01
Preoperative (a) plain computed tomography (CT) and (b) CT angiography of case 1.
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F1
Three-dimensional computed tomography (CT) scan revealed diffuse thickened SAH [Figure 1a] and an upward-protruding AcomA aneurysm [Figure 1b].
Postoperative (a) plain computed tomography and (b) diffusion weighted-magnetic resonance imaging of case 1.
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F2
Postoperatively, CT scan demonstrated that tip of the cisternal drain was placed at the interpeduncular fossa [Figure 2a], and diffusion-weighted magnetic resonance imaging (MRI) revealed a left paramedian thalamic infarction [Figure 2b].
Postoperative (a) digital subtraction angiography and (b) plain computed tomography (sagittal image) of case 1.
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F3
Postoperative CT and digital subtraction angiography (DSA) showed the tip of cisternal drain placed above the basilar bifurcation [Figure 3].
PMC7332699_02
Preoperative (a) plain computed tomography and (b) digital subtraction angiography of case 2.
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F4
The image findings revealed diffuse SAH [Figure 4a] because of a ruptured AcomA aneurysm, which was high-positioned relative to the tuberculum sellae, and somewhat posteriorly projected [Figure 4b].
Postoperative (a) plain computed tomography and (b) diffusion weighted-magnetic resonance imaging of case 2.
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F5
On day 1, MRI demonstrated acute ischemia in the right anterior- medial thalamus [Figure 5]. On day 4, postoperative intermittent Urokinase injection and cerebrospinal fluid drainage almost completely removed the cisternal clot [Figure 5].
Postoperative digital subtraction angiography of case 2.
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F6
By reviewing the preoperative lateral VAG in DSA, the location of the basilar bifurcation was estimated as below the anterior clinoid-posterior clinoid line [Figure 6].
Postoperative 14 months T2-weighted magnetic resonance imaging of case 2.
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F7
Postoperative 14 months T2-weighted MRI demonstrated only a tiny residual chronic ischemic lesion in the corresponding right thalamic area [Figure 7].