What is pseudomeningocele formation?

What is pseudomeningocele formation?

Postsurgical pseudomeningocele is created when CSF extravasates through a dura-arachnoid tear and becomes encysted within the wound, in a fibrous capsule, lying adjacent to the spinal canal. Its exact incidence is difficult to estimate as majority of them remain asymptomatic and go unnoticed.

What causes pseudomeningocele?

Pseudomeningoceles are caused either by herniation of the arachnoid through a dural tear, which forms an arachnoid-lined sac filled with CSF,17 or by direct extravasation of CSF into the soft tissues, with eventual development of a fibrous capsule.

What is a large pseudomeningocele?

A giant pseudomeningocele is defined as a lesion ≥ 8 cm in diameter[4] and only 17 cases of giant pseudomeningoceles (Table ​1) have been reported in the literature[4,9,10-12]. Of these 17 cases, 11 patients were men (64.7%) and 6 were women (35.3%). The mean age of the patients was 39.7 years (range 19-68 years).

What is a Durotomy?

Incidental durotomy refers to unintended tears or puncture of the dura mater: the tough outer membrane covering the spinal cord. Dural tears occur frequently during spinal surgery; when promptly recognized and repaired, they generally cause no long-term problems.

What are the symptoms of pseudomeningocele?

A pseudomeningocele can cause symptoms of postural headache, blurry vision, dizziness, diplopia, photophobia, tinnitus, back pain, leg pain and radicular symptoms, nausea, and vomiting, and in a rare case, it has even caused tracheal obstruction.

How do you treat pseudomeningocele?

A combined treatment protocol involving open revision surgery for extirpation of the pseudomeningocele, repair of dural tears, and implantation of a subarachnoid catheter for drainage is safe and effective to treat giant pseudomeningoceles.

Can pseudomeningocele be cured?

Is a pseudomeningocele serious?

Conclusions: Incidental durotomy and repair causing a large compressive pseudomeningocele after spine surgery is a rare and potentially devastating event. Early postoperative magnetic resonance imaging assists in the diagnosis.

How is pseudomeningocele treated?

How do you fix pseudomeningocele?

Whereas the goals of pseudomeningocele repair, which are extirpation of the pseudomeningocele cavity and elimination of extradural dead space, can typically be achieved by primary closure performed using nonabsorbable sutures, giant pseudomeningoceles (> 8 cm) can require more elaborate repair in which fibrin glues.

What does pseudomeningocele stand for in medical terms?

Abnormal collection of cerebrospinal fluid (CSF) that communicates with the CSF space around the brain or spinal cord. Pseudomeningocele is the term used to describe fluid accumulation due to the leakage of cerebrospinal fluid into the surrounding soft tissue.

Where is the fluid located in a pseudomeningocele?

In contrast to a meningocele, in which the fluid is surrounded and confined by dura mater, in a pseudomeningocele, the fluid has no surrounding membrane but is contained in a cavity within the soft tissues.

When does a pseudomeningocele develop in the dura?

Pseudomeningoceles generally develop following an intraoperative rent in the dura and arachnoid, but can occur following dural needle puncture procedures, especially after multiple punctures.9 The cerebrospinal fluid leaks dorsal to the lamina, into a space artificially created by dissection of the paravertebral musculature.

Why do I have a headache with pseudomeningocele?

Most of the patients with pseudomeningocele report headache. Sometimes the leakage may find it’s way to the spinal canal i.e. epidural space or in the introductory case i.e. subdural space. The most common cause reported behind pseudomeningocele is the cervical surgery.