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Richardson WT, Bhenderu LSS, Soto JM, Garrett D. Surgical management of an ossified giant lumbar pseudomeningocele: A case report. Surg Neurol Int 2023; 14:244. [PMID: 37560586 PMCID: PMC10408631 DOI: 10.25259/sni_475_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 06/22/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Pseudomeningoceles (PMs) are infrequent complications of spine surgery resulting from incidental durotomy and subsequent extravasation of cerebrospinal fluid. Giant PMs (GPMs), defined as ≥8 cm in major diameter, are rarely reported in the literature and present a challenge due to a lack of clear guidelines for surgical management. CASE DESCRIPTION Here, the authors discuss the successful surgical management of a 25.3 cm lumbar GPM that became calcified 3 years following an initial T10-S2 laminectomy with instrumented fusion performed at an outside-hospital. CONCLUSION This report focuses on the successful 3-year delayed surgical intervention for the management of an ossified GPM.
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Affiliation(s)
| | | | - Jose M. Soto
- Department of Neurological Surgery, Baylor Scott and White, Temple, Texas, United States
| | - David Garrett
- Department of Neurological Surgery, Baylor Scott and White, Temple, Texas, United States
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Koyama J, Akutsu N, Higashino M, Motohiro O, Kawamura A. Repair of refractory postoperative cerebrospinal fluid leakage using a reversed dermis flap in a pediatric lipomyelomeningocele patient. Childs Nerv Syst 2022; 38:1185-1188. [PMID: 35536350 DOI: 10.1007/s00381-022-05474-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/05/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Cerebrospinal fluid (CSF) leak and pseudomeningocele are common complications after surgery for spinal dysraphism. CASE REPORT AND TECHNIQUE We report a 6-month-old girl with a lumbosacral lipomyelomeningocele and accessory lower limb who developed a refractory cerebrospinal fluid leak and pseudomeningocele after lipomyelomeningocele repair and removal of the accessory limb. The pseudomeningocele was successfully repaired using a reversed dermis flap made from excess skin that covered the meningocele. CONCLUSION This technique can be performed without using synthetic material or an additional surgical incision.
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Affiliation(s)
- Junji Koyama
- Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Nobuyuki Akutsu
- Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Masashi Higashino
- Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Onoda Motohiro
- Department of Plastic Surgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Atsufumi Kawamura
- Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
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d'Esneval M, Zegarek G, Pugin D, Vargas MI, Tessitore E, Vulliemoz S. Giant Lumbar Pseudomeningocele Compression Mimicking Stroke and Seizure. Neurol Clin Pract 2021; 11:e763-e765. [PMID: 34840902 DOI: 10.1212/cpj.0000000000001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/14/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Mathilde d'Esneval
- Department of Neurology (MdE, SV), Department of Neurosurgery (GZ, ET), Intensive Care Unit (DP), Department of Acute Medicine, Division of Neuroradiology (MIV), Geneva University Hospitals, Switzerland
| | - Gregory Zegarek
- Department of Neurology (MdE, SV), Department of Neurosurgery (GZ, ET), Intensive Care Unit (DP), Department of Acute Medicine, Division of Neuroradiology (MIV), Geneva University Hospitals, Switzerland
| | - Deborah Pugin
- Department of Neurology (MdE, SV), Department of Neurosurgery (GZ, ET), Intensive Care Unit (DP), Department of Acute Medicine, Division of Neuroradiology (MIV), Geneva University Hospitals, Switzerland
| | - Maria Isabel Vargas
- Department of Neurology (MdE, SV), Department of Neurosurgery (GZ, ET), Intensive Care Unit (DP), Department of Acute Medicine, Division of Neuroradiology (MIV), Geneva University Hospitals, Switzerland
| | - Enrico Tessitore
- Department of Neurology (MdE, SV), Department of Neurosurgery (GZ, ET), Intensive Care Unit (DP), Department of Acute Medicine, Division of Neuroradiology (MIV), Geneva University Hospitals, Switzerland
| | - Serge Vulliemoz
- Department of Neurology (MdE, SV), Department of Neurosurgery (GZ, ET), Intensive Care Unit (DP), Department of Acute Medicine, Division of Neuroradiology (MIV), Geneva University Hospitals, Switzerland
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