Spontaneous resolution of postoperative giant frontal pseudomeningocele

Duc Tran; Thi Dinh; Quoc Nguyen; Dang Mai; Van Truong

doi:10.4103/ajns.AJNS_18_21

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(02): 372-375
DOI: 10.4103/ajns.AJNS_18_21

Case Report

Spontaneous resolution of postoperative giant frontal pseudomeningocele

Authors

Duc Tran^*

¹Department of Neurosurgery, Hue University Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue

²Department of Neurosurgery, Xuyen A Hospital, Ho Chi Minh City
Thi Dinh^*

¹Department of Neurosurgery, Hue University Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue
Quoc Nguyen

¹Department of Neurosurgery, Hue University Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue
Dang Mai

¹Department of Neurosurgery, Hue University Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue
Van Truong

¹Department of Neurosurgery, Hue University Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue

³Vietnam; Division of Orthopedics, Central Hospital of University of Montreal, University of Montreal, Montreal, Canada

Abstract

Cranial pseudomeningoceles are abnormal extradural collections of cerebrospinal fluid. Postoperative giant cranial pseudomeningoceles have been rarely reported in the literature and have no specific treatment guidelines. The optimal management strategy for this condition differs among authors, varying from conservative approach to surgical intervention. A spontaneous resolution of postoperative giant frontal pseudomeningocele is reported. A 41-year-old female presented a pseudomeningocele 3 weeks after a right frontal meningioma surgical resection. The pseudomeningocele progressed during the first 1.5-month postoperatively despite percutaneous aspiration and compressive bandage, it then shrank spontaneously and was completely resolved at the 15^th month since the surgery. Nonoperative treatment with a close follow-up could be a good option for asymptomatic giant pseudomeningoceles, resulting in a spontaneous resolution.

Key-words:

Conservative treatment - craniotomy - giant - pseudomeningocele - resolution

Full Text

References

References
1 Couture D, Branch CL Jr. Spinal pseudomeningoceles and cerebrospinal fluid fistulas. Neurosurg Focus 2003;15:E6.
2 Mehendale NH, Samy RN, Roland PS. Management of pseudomeningocele following neurotologic procedures. Otolaryngol Head Neck Surg 2004;131:253-62.
3 Zide BM. How to reduce the morbidity of wound closure following extensive and complicated laminectomy and tethered cord surgery. Pediatr Neurosurg 1992;18:157-66.
4 Steinbok P, Singhal A, Mills J, Cochrane DD, Price AV. Cerebrospinal fluid (CSF) leak and pseudomeningocele formation after posterior fossa tumor resection in children: A retrospective analysis. Childs Nerv Syst 2007;23:171-4.
5 Hawk MW, Kim KD. Review of spinal pseudomeningoceles and cerebrospinal fluid fistulas. Neurosurg Focus 2000;9:e5.
6 Manley GT, Dillon W. Acute posterior fossa syndrome following lumbar drainage for treatment of suboccipital pseudomeningocele. Report of three cases. J Neurosurg 2000;92:469-74.
7 Smith GA, Strohl MP, Manjila S, Miller JP. Incidence, management, and outcome of symptomatic postoperative posterior fossa pseudomeningocele: A retrospective single-institution experience. Oper Neurosurg (Hagerstown) 2016;12:298-304.
8 Chiang JY, Lin HL. Life-threatening posterior fossa cyst induced by pseudomeningocele after operation for acoustic neuroma. Surg Neurol Int 2015;6 Suppl 2:S101-3.
9 Pirouzmand F, Tator CH, Rutka J. Management of hydrocephalus associated with vestibular schwannoma and other cerebellopontine angle tumors. Neurosurgery 2001;48:1246-53.
10 Tu A, Tamburrini G, Steinbok P. Management of postoperative pseudomeningoceles: An international survey study. Childs Nerv Syst 2014;30:1791-801.
11 hyndman OR, GERBER WF. Spinal extradural cysts, congenital and acquired; report of cases. J Neurosurg 1946;3:474-86.
12 Miller PR, Elder FW Jr. Meningeal pseudocysts (meningocele spurius) following laminectomy. Report of ten cases. J Bone Joint Surg Am 1968;50:268-76.
13 Weng YJ, Cheng CC, Li YY, Huang TJ, Hsu RW. Management of giant pseudomeningoceles after spinal surgery. BMC Musculoskelet Disord 2010;11:53.
14 Srilomsak P, Okuno K, Sakakibara T, Wang Z, Kasai Y. Giant pseudomeningocele after spinal surgery: A case report. World J Orthop 2012;3:109-13.
15 Cobb C 3rd, Ehni G. Herniation of the spinal cord into an iatrogenic meningocele. Case report. J Neurosurg 1973;39:533-6.
16 Tsuji H, Handa N, Handa O, Tajima G, Mori K. Postlaminectomy ossified extradural pseudocyst. Case report. J Neurosurg 1990;73:785-7.
17 Aoki N. Lumboperitoneal shunt for the treatment of postoperative persistent collection of subcutaneous cerebrospinal fluid (pseudomeningocoele). Acta Neurochir (Wien) 1989;98:32-4.
18 Waisman M, Schweppe Y. Postoperative cerebrospinal fluid leakage after lumbar spine operations. Conservative treatment. Spine (Phila Pa 1976) 1991;16:52-3.
19 Birkholz SE, Patil AA, Chamczuk AJ, Treatment of postoperative recurrent cerebrospinal fluid leak with pseudo-meningocele formation using temporary epidural drain. Interdiscip Neurosurg 2019;16:25-8.
20 Pahys JM, Chicorelli AM, Asghar J, Betz RR, Samdani AF. Cervical pseudomeningocele due to occult hydrocephalus. Spine (Phila Pa 1976) 2008;33:E394-6.
21 Solomon P, Sekharappa V, Krishnan V, David KS. Spontaneous resolution of postoperative lumbar pseudomeningoceles: A report of four cases. Indian J Orthop 2013;47:417-21.
22 Clarke A, Hutton M. Spontaneous resolution of a massive pseudomeningocoele. Acta Orthop Belg 2009;75:277-9.