Case Notes
History
55 yo male with prior head CT revealing multiple calcific cystic lesion and normal ventricular size for chronological age. There had been a previous suboccipital craniotomy with partial removal of a lower pontomedullary cyst. Five months later the patient developed increasing headaches and CT evidence of internal obstructive hydrocephalus. The patient underwent a right VP shunt and midline suboccipital craniotomy for drainage of a sizable pontine cavernous malformation.Exam
MR T1-w pre contrast
Prior Study
CT Head pre contrast1. Multiple brain cavernous angiomas.
2. Evidence of internal type of hydrocephalus with block likely at the outlet of the fourth ventricle.
3. Prior suboccipital craniotomy for drainage of a lower brain stem cyst.