Presentation
Post left trigeminal nerve microvascular decompression.
Patient Data
Surgical material is noted in the region of the cisternal left trigeminal nerve. Wedge-shaped region of hypoattenuation involving the superior and lateral aspect of the left cerebellar hemisphere does not conform to an arterial vascular territory, in keeping with a venous infarct. Anteriorly there is a small amount of hyperdense blood which is likely subarachnoid. There is mild mass-effect within the posterior cranial fossa, with displacement of the fourth ventricle to the right. No supratentorial midline shift or hydrocephalus. No hypodensity within the left sigmoid and transverse sinus.
Case Discussion
The neurosurgeon confirmed a small vein draining into the sigmoid sinus was injured during the procedure and had to be sacrificed.