Radiologic Evaluation and Management of Postoperative Spine Paraspinal Fluid Collections

Jain, Nikhil; Dao, Kimberly; Ortiz, A. Orlando

doi:10.1016/j.nic.2014.01.001

Cited by 25 publications

(22 citation statements)

References 22 publications

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“…1,3,5,6 Distinguishing between these two lesions is paramount given the differences in management. Similar to pseudomeningoceles, mucoceles can expand in size to cause progressive remodeling of the surrounding bony structures.…”

Section: Discussionmentioning

confidence: 99%

“…Both lesions are seen on computed tomography as homogenous and airless fluid-density filled, expansile, nonenhancing sinus masses with gradual thinning and erosion of the bony margins. 5,6 On magnetic resonance imaging, mucoceles may exhibit variable signal intensities on both T1-and T2-weighted images, depending on their state of hydration and viscosity. 5 In long-standing collections where there is high water content and low viscosity, mucoceles may display similar density and intensity to CSF on computed tomography and magnetic resonance imaging, respectively, making distinguishing between mucocele and pseudomucocele difficult.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Giant Pseudomeningocele in the Middle Cranial Fossa as a Cause of Pulsatile Proptosis

Nguyen

Guiney

Iseli³

et al. 2017

Ophthalmic Plastic &Amp; Reconstructive Surgery

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The authors report a case of a 70-year-old man who presented with a long history of left pulsatile proptosis, irritation, and a pressure sensation behind the eye. Initial computed tomography brain demonstrated the presence of a suspected ethmoid sinus mucocele. Endoscopic sinus surgery was performed to drain the mucocele. On cautious opening of the nasal mucosa, cerebrospinal fluid was encountered requiring subsequent repair with local mucosal flap and fat graft. On further magnetic resonance imaging, the lesion was confirmed to be giant pseudomeningocele arising from the sphenoid sinus, with extensive invasion and erosion of the middle cranial fossa including the left lateral orbital wall. Here, the authors report, to the best of their knowledge, the first case of spontaneous giant pseudomeningocele in the middle cranial fossa causing pulsatile proptosis. In examining this case, the authors will also discuss the pathogenesis, diagnosis, and management of giant pseudomeningoceles, especially in the situation of a misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spontaneous Giant Pseudomeningocele in the Middle Cranial Fossa as a Cause of Pulsatile Proptosis

Nguyen

Guiney

Iseli³

et al. 2017

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

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“…Imaging for new or residual infection in the postoperative setting presents unique challenges related to postoperative findings that can mimic infection, such as seroma formation and enhancing granulation tissue 46 . DOM as a complication of spine disc surgery is fortunately a relatively infrequent occurrence 3, 47 .…”

Section: Special Considerationsmentioning

confidence: 99%

Imaging-Based Approach to Extradural Infections of the Spine

Talbott

Shah

Uzelac

et al. 2018

Seminars in Ultrasound, CT and MRI

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“…1 Durotomies during spinal surgery are not uncommon. While the majority of durotomies heal after primary closure, in some cases the inability to obtain a watertight closure may lead to ongoing CSF egress.…”

Section: Introductionmentioning

confidence: 99%

“…Pseudomeningocoele (PMC) is an abnormal collection of cerebrospinal fluid (CSF) that communicates with the subarachnoid space and extends from the spinal canal to the adjacent paraspinal soft tissue. 1 Durotomies during spinal surgery are not uncommon. While the majority of durotomies heal after primary closure, in some cases the inability to obtain a watertight closure may lead to ongoing CSF egress.…”

Section: Introductionmentioning

confidence: 99%

Rare Complications of Cervical Spine Surgery: Pseudomeningocoele

Ailon

Smith

Nassr

et al. 2017

Global Spine Journal

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Study Design:This study was a retrospective, multicenter cohort study.Objectives:Rare complications of cervical spine surgery are inherently difficult to investigate. Pseudomeningocoele (PMC), an abnormal collection of cerebrospinal fluid that communicates with the subarachnoid space, is one such complication. In order to evaluate and better understand the incidence, presentation, treatment, and outcome of PMC following cervical spine surgery, we conducted a multicenter study to pool our collective experience.Methods:This study was a retrospective, multicenter cohort study of patients who underwent cervical spine surgery at any level(s) from C2 to C7, inclusive; were over 18 years of age; and experienced a postoperative PMC.Results:Thirteen patients (0.08%) developed a postoperative PMC, 6 (46.2%) of whom were female. They had an average age of 48.2 years and stayed in hospital a mean of 11.2 days. Three patients were current smokers, 3 previous smokers, 5 had never smoked, and 2 had unknown smoking status. The majority, 10 (76.9%), were associated with posterior surgery, whereas 3 (23.1%) occurred after an anterior procedure. Myelopathy was the most common indication for operations that were complicated by PMC (46%). Seven patients (53%) required a surgical procedure to address the PMC, whereas the remaining 6 were treated conservatively. All PMCs ultimately resolved or were successfully treated with no residual effects.Conclusions:PMC is a rare complication of cervical surgery with an incidence of less than 0.1%. They prolong hospital stay. PMCs occurred more frequently in association with posterior approaches. Approximately half of PMCs required surgery and all ultimately resolved without residual neurologic or other long-term effects.

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Radiologic Evaluation and Management of Postoperative Spine Paraspinal Fluid Collections

Cited by 25 publications

References 22 publications

Spontaneous Giant Pseudomeningocele in the Middle Cranial Fossa as a Cause of Pulsatile Proptosis

Spontaneous Giant Pseudomeningocele in the Middle Cranial Fossa as a Cause of Pulsatile Proptosis

Imaging-Based Approach to Extradural Infections of the Spine

Rare Complications of Cervical Spine Surgery: Pseudomeningocoele

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