Surgical management of a retropharyngeal pseudomeningocele: Case report

Alotaibi, Naif H.; AlShehri, Abdullah J.; Alshankiti, Osamah H.; Althubaiti, Ibrahim

doi:10.1016/j.ijscr.2020.09.191

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…To the best of our knowledge, we found only 10 reported cases of retropharyngeal pseudomeningocele, seven of them as a sequalae of atlanto-occipital dislocation (AOD), two of them as case of atlantoaxial dislocation, and one of them as a case of C5-C6 subluxation (►Table 1). 1,3,[8][9][10][11][12][13][14] To our knowledge, this is the second reported occurrence of a prevertebral retropharyngeal pseudomeningocele, following dislocation of the lower cervical spine.…”

Section: Discussionmentioning

confidence: 78%

“…3 However, surgical repair of retropharyngeal pseudomeningocele was challenging for some cases, because of the following: difficulty in approaching the site of the defect, increased risk of developing meningitis, or severe morbidity such as poor neurological function. 14 Alatoibi et al reported the first case of direct repair of defect using muscle graft and TISSEL fibrin sealant. 14 In the present case, there were no direct visual evidence of dural tear, and CSF was seen only on Valsalva maneuver; therefore, the repair was done using fat graft and TISSEL fibrin sealant at C6-C7 level after discectomy followed by C6-C7 fusion.…”

Section: Discussionmentioning

confidence: 99%

“…14 Alatoibi et al reported the first case of direct repair of defect using muscle graft and TISSEL fibrin sealant. 14 In the present case, there were no direct visual evidence of dural tear, and CSF was seen only on Valsalva maneuver; therefore, the repair was done using fat graft and TISSEL fibrin sealant at C6-C7 level after discectomy followed by C6-C7 fusion.…”

Section: Discussionmentioning

confidence: 99%

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Posttraumatic Retropharyngeal Pseudomeningocele—A Case Report

Tyngkan

Singh

Mathew

et al. 2021

Indian Journal of Neurotrauma

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A retropharyngeal pseudomeningocele after cervical vertebral fracture dislocation is an extremely rare complication and often associated with hydrocephalus. It usually presents with respiratory difficulty and dysphagia, sometimes as an incidental finding in radiological study. We reported a case of 45-year-old female patient who had posttraumatic lower cervical prevertebral retropharyngeal pseudomeningocele, found as an incidental finding in a routine radiological workup. Patient underwent ACDF but expired 2 weeks postoperatively due to respiratory failure. Although the prognosis of retropharyngeal pseudomeningocele depends upon the severity of initial trauma, early recognition and management can prevent enlargement of cyst and development of respiratory difficulty and dysphagia.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Posttraumatic Retropharyngeal Pseudomeningocele—A Case Report

Tyngkan

Singh

Mathew

et al. 2021

Indian Journal of Neurotrauma

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“…While there are several different techniques to address dural tears [5] , [6] , [7] , [8] , their persistence can be problematic [1] , [9] . Several case reports detail pseudomeningoceles causing airway obstruction, dysphagia, and headaches [10] , [11] , [12] , [13] . Pseudomeningoceles have also been associated with loss of consciousness in Marfan syndrome secondary to intracranial pressure changes [14] as well as syncope and transient anoxic seizures [15] .…”

Section: Introductionmentioning

confidence: 99%

Anterior cervical pseudomeningocele causing syncope after spinal surgery: A case report

Ehsanian

Ali

Singh

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance Pseudomeningocele formation from incidental durotomy is a known risk in spine surgery. We present a case of incidental durotomy leading to anterior neck pseudomeningocele, compressing the carotid body (CB) resulting in syncopal episodes. To our knowledge, this is the first case report implicating syncopal episodes to CB compression via a pseudomeningocele. Case presentation A mid sixty-year-old patient with history of obesity, hypertension, and diabetes presented with gait impairment and hand weakness. Ossification of posterior longitudinal ligament (OPLL) was diagnosed with computed tomography imaging (CT) and magnetic resonance imaging (MRI). Elective surgery was completed with an anterior and posterior approach for decompression and fusion. Hospital course (San Jose, CA, USA) was complicated by respiratory depression and incomplete tetraplegia. On post-operative day (POD) six, CT revealed anterolateral soft tissue neck swelling; subsequent CT and MRI showed fluid collection expansion, with associated syncopal episodes on POD thirty-nine. Despite interventional radiology drainage, the fluid collection and symptoms returned five days later. The patient ultimately underwent durotomy revision and repair with muscle patch. Clinical discussion This case highlights the challenges in managing anterior cervical dural tears resulting in pseudomeningocele. Risk factors include anterior cervical corpectomy and decompression, as well as an underlying diagnosis of OPLL. Untreated dural tears may develop into pseudomeningoceles which can contribute to life-threatening outcomes. Conclusion This case report presents the serious consequences of incidental durotomy, the unique post-surgical complication of syncope due to compression of the CB from a pseudomeningocele, and the challenges of managing a persistent pseudomeningocele.

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Management of Post-Traumatic Pseudomeningocele as Consequence of Root Nerve Avulsion: Case Report and Review of the Literature

Bradaschia,

Lacatena,

Vincitorio

et al. 2024

Neurology International

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Background: Post-traumatic pseudomeningoceles are common findings after a brachial or lumbar plexus trauma, in particular after nerve root avulsion. Unlike meningoceles, pseudomeningoceles are CSF full-filled cysts confined by the paraspinous soft tissue, along the normal nerve course, in communication with the spinal subarachnoid spaces. Normally no more than a radiological finding at MRI, in rare instances they might be symptomatic due to their size or might constitute an obstacle during a reconstructive surgery. Methods: A review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a time span ranging from November 1972 to May 2024. A total of five articles were found meeting the inclusion criteria. A case report at our institution was added to the case history. Results: A 30-year-old man with complete right brachial plexus nerve roots avulsion and a voluminous pseudomeningocele at the C6-C7 level after a motorcycle incident in January 2023. The pseudomeningocele covered the entirety of the injured brachial plexus. Pre-operative external lumbar drainage was utilized to prevent relapse or worsening of the already existing cerebral spinal fluid collection, with good results at 6 months. The full case report is reported in detail. Conclusions: To date, no clear guidelines about the management of post-traumatic pseudomeningoceles are reported in the literature. The lack of symptoms or signs related to them does not usually require any surgical intervention. If not, a possible management strategy with the use of an external lumbar drainage is proposed, a solution already in use in other surgical contexts with successful results in preventing CSF fistula or its relapse.

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Surgical management of a retropharyngeal pseudomeningocele: Case report

Cited by 3 publications

References 16 publications

Posttraumatic Retropharyngeal Pseudomeningocele—A Case Report

Posttraumatic Retropharyngeal Pseudomeningocele—A Case Report

Anterior cervical pseudomeningocele causing syncope after spinal surgery: A case report

Management of Post-Traumatic Pseudomeningocele as Consequence of Root Nerve Avulsion: Case Report and Review of the Literature

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