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Letter to Editor
15 (
1
); 165-166
doi:
10.25259/JNRP_238_2023

Bochdalek flower basket sign

Department of Radiodiagnosis, Katuri Medical College, Guntur, Andhra Pradesh, India
Corresponding author: Ramakrishna Narra, Department of Radiodiagnosis, Katuri Medical College, Guntur, Andhra Pradesh, India. narra.ramki29@outlook.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Narra R, Burudi P. Bochdalek flower basket sign. J Neurosci Rural Pract. 2024;15:165-6. doi: 10.25259/JNRP_238_2023

Dear Editor,

A 62-year-old male patient complained of recurrent headaches for one month. On routine computed tomography imaging, linear calcification was noted in the fourth ventricle extending laterally into foramen of Luschka, described radiological as Bochdalek flower basket sign [Figure 1a-c].

Figure 1:
(a) Axial computed tomography of brain, (b) maximum intensity projection computed tomography, (c) schematic diagram of fourth ventricle choroid plexus demonstrating the classical flower basket appearance (black arrows), the medial vertical segment of the choroid plexus (open arrows), and horizontal segment of choroid plexus (arrow heads) that project into foramen of Luschka.

Bochdalek flower basket sign is an eponymous word described by Vincent Bochdalek, a Czech anatomist, for protruded fourth ventricle choroid plexus through foramen of Luschka into cerebellopontine-cistern. Calcification of fourth ventricle choroid plexus is noted in 8% of patients aged about 60. However, complete calcification with a typical flower basket appearance is rare.

Developmentally fourth ventricle choroid plexus is composed of two inverted L-shaped structures. Two vertical limbs on each side of the midline extend into foramen of Magendie. Two transverse limbs extend laterally through foramen of Luschka and reach cerebellopontine fissures. These terminal parts of lateral segments protruding through foramen of Luschka have been named Bochdalek’s flower basket.[1] It is essential radiologically to recognize the entity, as it could be misdiagnosed as a subarachnoid hemorrhage or vertebral artery/posterior inferior cerebellar artery aneurysm or even bilateral choroid plexus lymphomas.[2]

Ethical approval

The Institutional Review Board approval is not required.

Declaration of patient consent

Patient’s consent not required as patients identity is not disclosed or compromised.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

References

  1. , , . Bochdalek's flower basket: Applied neuroimaging morphometry and variants of choroid plexus in the cerebellopontine angles. Neuroradiology. 2012;54:1341-6.
    [CrossRef] [PubMed] [Google Scholar]
  2. , , , , , . Morphometry and microsurgical anatomy of Bochdalek's flower basket and the related structures of the cerebellopontine angle. Acta Neurochir (Wien). 2017;159:1539-45.
    [CrossRef] [PubMed] [Google Scholar]

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