What treatment options exist?
Surgical exploration and endovascular embolisation are the two options.
Blood is seen in the fourth ventricle (V4), ascending via the aqueduct of Sylvius (AS) into the third ventricle (V3) and into the frontal horns of the lateral ventricles (FH). The ventricles are distended, consistent with hydrocephalus, best seen as dilatation of the temporal horns (TH).
On CTA a 3mm 'blob' of contrast is seen near the midline on the left (red arrow), which on angiography is seen to arise from an enlarged PICA (red dotted line), which is contributing to a superficial arteriovenous malformation (yellow dotted line) posteriorly.