Traumatic anterior cervical pseudomeningocele causing intracranial hypotension successfully treated with blood patch: case report

Takahashi, Edwin A.; Eckel, Laurence J.; Diehn, Felix E.; Schwartz, Kara M.; Hunt, Christopher H.; Daniels, David J.

doi:10.3171/2014.12.spine14735

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…9 While the use of aspiration and blood patch has been previously described in cases of post-operative lumbar pseudomeningoceles, [2][3][4][5][6] its effectiveness in cases of the posterior cervical spine have not been documented. One case report detailed the use of an epidural blood patch for a traumatic anterior cervical pseudomeningocele, 10 however to the best of our knowledge there have been no reported studies investigating its utility in managing posterior pseudomeningoceles. The relative scarcity of literature on the technique may be attributed to the lower overall prevalence of cervical versus lumbar pseudomeningoceles, which is thought to be due to the comparatively higher number of performed lumbar laminectomies.…”

Section: Discussionmentioning

confidence: 99%

Management of postoperative cervical pseudomeningocele with percutaneous aspiration and epidural blood patch

et al. 2022

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Introduction While epidural blood patch can be an effective management option in lumbar pseudomeningoceles in certain clinical settings, its utility in the cervical spine is unclear. The aim of this study was to evaluate the safety and effectiveness of percutaneous aspiration and autologous blood patch for post-operative durotomy related pseudomeningoceles within the cervical spine. Methods A single institution retrospective review detailing 3 patients with durotomy related pseudomeningocele following posterior cervical spine surgery was completed. Results In all three cases, aspiration with subsequent injection of autologous epidural blood patch successfully treated each pseudomeningocele. One patient required more than one intervention, while the other two were successfully treated after one procedure. All three patients improved clinically without need for additional surgery. Conclusion Percutaneous aspiration and epidural blood patch can be used to safely manage post-operative pseudomeningoceles within the posterior cervical spine.

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Section: Discussionmentioning

confidence: 99%

Management of postoperative cervical pseudomeningocele with percutaneous aspiration and epidural blood patch

et al. 2022

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“…It is known that traumatic anterior cervical pseudomeningoceles are extremely rare. 6 It is remarkable that these signs were seen in a four-year-old child and that the MRI scans are very illustrative.…”

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confidence: 93%

The illustrative neuroimaging findings of whiplash injury in a child

Keskin

Pirimoğlu

2022

Arch Iran Med

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“…Both presentations involved the lumbar spine with proposed mechanisms of changes in intracranial pressure or mechanical compression on the spinal cord (SC) leading to syncope. Cervical pseudomeningoceles have been reported to cause bradycardia, oxygen desaturation, and mental status changes [16] .…”

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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Traumatic anterior cervical pseudomeningocele causing intracranial hypotension successfully treated with blood patch: case report

Cited by 6 publications

References 12 publications

Management of postoperative cervical pseudomeningocele with percutaneous aspiration and epidural blood patch

Management of postoperative cervical pseudomeningocele with percutaneous aspiration and epidural blood patch

The illustrative neuroimaging findings of whiplash injury in a child

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

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