Pseudomeningocele after Traumatic Nerve Root Avulsion

Abstract

<jats:p> Traumatic brachial plexus complete avulsions and the subsequent formation of pseudomeningoceles are a well-known entity that usually remains asymptomatic. Pseudomeningocele is due to the dural sleeve encasing the damaged roots and the spinal liquid that may accumulate locally or in the supraclavicular soft tissues. The pseudomeningocele, added to the associated lesion of the plexus and usually the surrounding vessels, may become difficult to manage. We describe the novel management of a traumatic pseudomeningocele using an endovascular technique. </jats:p>

Spinal Cord Herniation into a Pseudomeningocele—A Delayed Presentation following a Traumatic Cervical Root Avulsion Injury

“…Symptomatic spinal cord herniation into a post-traumatic pseudomeningocele is rare but of clinical importance. It is disabling but a potentially treatable condition 1 2 Our case is made more interesting by the rare lateral direction of herniation and the clinical Brown-Sequard syndrome it produced; but the concept applies to any unexplained myelopathy with a history of trauma and the diagnosis should be considered.…”

“…Traumatic spinal cord herniation is a very rare entity, with only 13 cases reported previously. 1 2 3 4 5 6 Pseudomeningoceles arising from nerve root avulsions are a particularly rare subtype of post-traumatic pseudomeningocele and we are only aware of five similar cases (only two of which presented as Brown-Sequard syndrome). 2 3 4 5 6 In interesting contrast, Brown-Sequard syndrome is the most common presentation of idiopathic cord herniations.…”

Treatment of Ruptured Meningocele Post-Brachial Plexus Surgery: Potential Life-Threatening Complication-An Unique Case Report of Management of Ruptured Meningocele Post-Brachial Plexus Surgery to Avoid Dreadful Complication

“…In literature, use of coils and embolizing by endovascular technique has been described for pseudomeningocele in root avulsions of brachial plexus [ 4 ] agents. Dural cystic lesions are very common findings to give false-positive or false-negative result on computed tomography (CT) myelography or MRI [ 5 ].…”

Cervical pseudomeningocele-induced hydrocephalus following traumatic brachial plexus injury-–a case report

“…This is critical as dismissal of early signs of intracranial hypertension such as dizziness, headaches, and nausea can have fatal consequences. Furthermore, it is important to not confound an abnormal supraclavicular mass in post-traumatic patients with other etiologies such as injuries to the bone or to the vasculature (subclavian artery pseudoaneurysm) [7,26,27]. A detailed physical examination evaluating for the presence of murmur, pulse, presence of Horner's syndrome, dizziness and/or headache that can be induced by manual compression of the bulge, is critical in making the correct diagnosis.…”