Intradiploic pseudomeningocele and ossified occipitocervical pseudomeningocele after decompressive surgery for Chiari I malformation: report of two cases and literature review

Kurzbuch, Arthur R.; Magdum, Shailendra; Jayamohan, Jayaratnam

doi:10.1007/s10143-017-0828-x

Cited by 6 publications

(15 citation statements)

References 21 publications

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“…7 8 9 When this fails, there occurs accumulation of CSF within the diploe, leading to widening of outer and inner tables due to the water-hammer effect of CSF accumulations. 2 In the present case, the pseudomeningocele is probably a result of shunt malfunction followed by increased CSF pressure, leading to accumulate CSF in the extradural space.…”

Section: Discussionmentioning

confidence: 58%

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Ossified Occipital Pseudomeningocele following Ventriculoperitoneal Shunt Malfunction

Bhatt

Mishra

Mhatre

et al. 2019

Journal of Neurosciences in Rural Practice

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Ossification of pseudomeningocele is a rare occurrence and is one of the rare complications of ventriculoperitoneal (VP) shunt malfunction. We report a case of 12-year-old boy who came with features of raised intracranial pressure following shunt malfunction which was placed as a treatment to the aqueductal stenosis. Computed tomography showed ventriculomegaly and hypodense collection in the occiput with posterior rim of calcification. The findings were confirmed on histopathology. Although ossified pseudomeningocele is a rare entity following VP shunt placement, it should be suspected if patients present with aggravated symptoms, especially if there is shunt malfunction as the treatment option varies with the presence or absence of resultant symptoms and ossification.

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Section: Discussionmentioning

confidence: 58%

“…Pseudomeningocele refers to CSF collections in cavities within the soft tissues or localized in calvarial bone diploe. 2 Pseudomenigocele can be congenital (nontraumatic) or traumatic. 3 4 The traumatic cause can be blunt trauma, inadvertent trauma to the dura, planned dural opening (surgery/ iatrogenic), infection, or intramural hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Ossified Occipital Pseudomeningocele following Ventriculoperitoneal Shunt Malfunction

Bhatt

Mishra

Mhatre

et al. 2019

Journal of Neurosciences in Rural Practice

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“…We have previously reported that in addition to the child in the present case, 6 patients with Chiari I malformation have been described thus far who postoperatively devel-oped an occipital intradiploic pseudomeningocele. 18,19 Three of these patients had undergone surgery with duraplasty, 3,11,23 and 3 without dural closure. 18,19 To the best of our knowledge we present here the first report of a patient who initially developed an occipital intradiploic pseudomeningocele and then a de novo cervical syrinx following decompressive surgery for Chiari I malformation.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 Three of these patients had undergone surgery with duraplasty, 3,11,23 and 3 without dural closure. 18,19 To the best of our knowledge we present here the first report of a patient who initially developed an occipital intradiploic pseudomeningocele and then a de novo cervical syrinx following decompressive surgery for Chiari I malformation.…”

Section: Discussionmentioning

confidence: 99%

“…After under-going radiological imaging, this patient was lost to followup without having revision surgery. 19 Then, after 4 years of loss to follow-up, she presented with an increase in the size of her intradiploic pseudomeningocele and a new cervical syrinx. We herein report the surgical revision performed in this patient and discuss possible underlying causes of both complications.…”

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confidence: 99%

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CSF goes astray no matter what is in the way: occipital intradiploic pseudomeningocele and de novo syringomyelia following foramen magnum decompression for Chiari I malformation in a pediatric patient

Kurzbuch

Magdum

2020

Journal of Neurosurgery: Pediatrics

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Nontraumatic intradiploic pseudomeningoceles and de novo syringomyelia formation are very rare entities. The authors have previously reported the case of a 4-year-old girl who underwent foramen magnum decompression without dural closure for Chiari I malformation. Three years after the operation an intradiploic pseudomeningocele was documented, but the patient was lost to follow-up without undergoing revision surgery. Four years later, at the age of 11 years, the patient returned for treatment of intensifying symptoms. Radiological imaging then showed an increase in the size of the intradiploic pseudomeningocele and a new cervical syrinx. The patient underwent a first revision surgery in which a part of the internal layer of the occipital bone was removed and arachnoid scar lysis was performed. Two months later the syrinx had worsened, and in a second revision surgery a pseudomeningocele-peritoneal shunt was placed. Here, the authors describe what is to their knowledge the first case of an intradiploic pseudomeningocele and de novo syringomyelia formation following Chiari I decompressive surgery.

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Rapid ossification of a giant post-operative occipital pseudomeningocele following posterior fossa surgery

2023

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Pseudomeningocele formation following posterior fossa surgery is a well-recognised complication, occurring in up to 33% of operated cases in some series. Ossification of a cranial pseudomeningocele is, however, an exceptionally rare event with only three prior reported cases. We present the unique case of a paediatric patient who developed rapid ossification of a giant occipital pseudomeningocele following posterior fossa surgery. An 8-year-old female patient underwent a midline posterior fossa craniotomy for resection of an exophytic brainstem low-grade glioma. Post-surgery, the patient developed pan-ventricular hydrocephalus and a large occipital pseudomeningocele, which initially increased in size despite a successful endoscopic third ventriculostomy (ETV) being performed. At approximately 3 months post-surgery, reduction of the pseudomeningocele was observed with associated prominent ossification of the pseudomeningocele wall on computed tomography (CT) imaging. Surgical excision was subsequently undertaken, and intra-operatively, a large ossified pseudomeningocele was found. Follow-up MRI 1 month later demonstrated almost complete resolution of the pseudomeningocele with an associated reduction in the degree of pan-ventricular ventriculomegaly. This case highlights that ossification of even giant pseudomeningoceles can occur over a time period of just a few months and clinicians should consider ossification whenever a change in size or consistency of a post-operative pseudomeningocele is encountered.

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Intradiploic pseudomeningocele and ossified occipitocervical pseudomeningocele after decompressive surgery for Chiari I malformation: report of two cases and literature review

Cited by 6 publications

References 21 publications

Ossified Occipital Pseudomeningocele following Ventriculoperitoneal Shunt Malfunction

Ossified Occipital Pseudomeningocele following Ventriculoperitoneal Shunt Malfunction

CSF goes astray no matter what is in the way: occipital intradiploic pseudomeningocele and de novo syringomyelia following foramen magnum decompression for Chiari I malformation in a pediatric patient

Rapid ossification of a giant post-operative occipital pseudomeningocele following posterior fossa surgery

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