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Pseudomeningocele
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Dural dehiscence, pseudocyst, CSF leak
              • Definitions

                • Spinal fluid collection contiguous with thecal sac, not lined with meninges

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nonvascular Interventions

                          • Other Modality Findings

                            • Imaging Recommendations

                              DIFFERENTIAL DIAGNOSIS

                                PATHOLOGY

                                • General Features

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Consider

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Drummond JC et al: Direct pressure on a pseudomeningocele resulting in intraoperative cerebral ischemia. Can J Anaesth. 61(7):656-9, 2014
                                                  2. Mihlon F et al: Computed tomography-guided epidural patching of postoperative cerebrospinal fluid leaks. J Neurosurg Spine. 1-6, 2014
                                                  3. Radcliff KE et al: Distinguishing pseudomeningocele, epidural hematoma, and postoperative infection on postoperative MRI. J Spinal Disord Tech. ePub, 2013
                                                  4. Horn EM et al: Spinal cord compression from traumatic anterior cervical pseudomeningoceles. Report of three cases. J Neurosurg Spine. 5(3):254-8, 2006
                                                  5. Scaduto AA et al: Perioperative complications of threaded cylindrical lumbar interbody fusion devices: anterior versus posterior approach. J Spinal Disord Tech. 16(6):502-7, 2003
                                                  6. Phillips CD et al: Depiction of a postoperative pseudomeningocele with digital subtraction myelography. AJNR Am J Neuroradiol. 23(2):337-8, 2002
                                                  7. Bosacco SJ et al: Evaluation and treatment of dural tears in lumbar spine surgery: a review. Clin Orthop Relat Res. (389):238-47, 2001
                                                  8. Elbiaadi-Aziz N et al: Cerebrospinal fluid leak treated by aspiration and epidural blood patch under computed tomography guidance. Reg Anesth Pain Med. 26(4):363-7, 2001
                                                  9. Jinkins JR et al: The postsurgical lumbosacral spine. Magnetic resonance imaging evaluation following intervertebral disk surgery, surgical decompression, intervertebral bony fusion, and spinal instrumentation. Radiol Clin North Am. 39(1):1-29, 2001
                                                  10. Ross JS: Magnetic resonance imaging of the postoperative spine. Semin Musculoskelet Radiol. 4(3):281-91, 2000
                                                  11. Stambough JL et al: Subarachnoid drainage of an established or chronic pseudomeningocele. J Spinal Disord. 13(1):39-41, 2000
                                                  12. Saunders RL et al: Four-level cervical corpectomy. Spine. 23(22):2455-61, 1998
                                                  13. McCormack BM et al: Pseudomeningocele/CSF fistula in a patient with lumbar spinal implants treated with epidural blood patch and a brief course of closed subarachnoid drainage. A case report. Spine. 21(19):2273-6, 1996
                                                  14. Aldrete JA et al: Postlaminectomy pseudomeningocele. An unsuspected cause of low back pain. Reg Anesth. 20(1):75-9, 1995
                                                  15. Hosono N et al: Postoperative cervical pseudomeningocele with herniation of the spinal cord. Spine. 20(19):2147-50, 1995
                                                  16. Lee KS et al: Postlaminectomy lumbar pseudomeningocele: report of four cases. Neurosurgery. 30(1):111-4, 1992
                                                  17. Shapiro SA et al: Closed continuous drainage of cerebrospinal fluid via a lumbar subarachnoid catheter for treatment or prevention of cranial/spinal cerebrospinal fluid fistula. Neurosurgery. 30(2):241-5, 1992
                                                  18. Murayama S et al: Magnetic resonance imaging of post-surgical pseudomeningocele. Comput Med Imaging Graph. 13(4):335-9, 1989
                                                  19. Schumacher HW et al: Pseudomeningocele of the lumbar spine. Surg Neurol. 29(1):77-8, 1988
                                                  20. Tuvia J et al: Visualization of a pseudomeningocele on isotope cisternography. Clin Nucl Med. 13(12):889-91, 1988
                                                  21. Teplick JG et al: CT Identification of postlaminectomy pseudomeningocele. AJR Am J Roentgenol. 140(6):1203-6, 1983
                                                  22. Eismont FJ et al: Treatment of dural tears associated with spinal surgery. J Bone Joint Surg Am. 63(7):1132-6, 1981
                                                  23. Helle TL et al: Postoperative cervical pseudomeningocele as a cause of delayed myelopathy. Neurosurgery. 9(3):314-6, 1981
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Synonyms

                                                                • Dural dehiscence, pseudocyst, CSF leak
                                                              • Definitions

                                                                • Spinal fluid collection contiguous with thecal sac, not lined with meninges

                                                              IMAGING

                                                              • General Features

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Ultrasonographic Findings

                                                                        • Nonvascular Interventions

                                                                          • Other Modality Findings

                                                                            • Imaging Recommendations

                                                                              DIFFERENTIAL DIAGNOSIS

                                                                                PATHOLOGY

                                                                                • General Features

                                                                                  • Gross Pathologic & Surgical Features

                                                                                    • Microscopic Features

                                                                                      CLINICAL ISSUES

                                                                                      • Presentation

                                                                                        • Demographics

                                                                                          • Natural History & Prognosis

                                                                                            • Treatment

                                                                                              DIAGNOSTIC CHECKLIST

                                                                                              • Consider

                                                                                                • Image Interpretation Pearls

                                                                                                  Selected References

                                                                                                  1. Drummond JC et al: Direct pressure on a pseudomeningocele resulting in intraoperative cerebral ischemia. Can J Anaesth. 61(7):656-9, 2014
                                                                                                  2. Mihlon F et al: Computed tomography-guided epidural patching of postoperative cerebrospinal fluid leaks. J Neurosurg Spine. 1-6, 2014
                                                                                                  3. Radcliff KE et al: Distinguishing pseudomeningocele, epidural hematoma, and postoperative infection on postoperative MRI. J Spinal Disord Tech. ePub, 2013
                                                                                                  4. Horn EM et al: Spinal cord compression from traumatic anterior cervical pseudomeningoceles. Report of three cases. J Neurosurg Spine. 5(3):254-8, 2006
                                                                                                  5. Scaduto AA et al: Perioperative complications of threaded cylindrical lumbar interbody fusion devices: anterior versus posterior approach. J Spinal Disord Tech. 16(6):502-7, 2003
                                                                                                  6. Phillips CD et al: Depiction of a postoperative pseudomeningocele with digital subtraction myelography. AJNR Am J Neuroradiol. 23(2):337-8, 2002
                                                                                                  7. Bosacco SJ et al: Evaluation and treatment of dural tears in lumbar spine surgery: a review. Clin Orthop Relat Res. (389):238-47, 2001
                                                                                                  8. Elbiaadi-Aziz N et al: Cerebrospinal fluid leak treated by aspiration and epidural blood patch under computed tomography guidance. Reg Anesth Pain Med. 26(4):363-7, 2001
                                                                                                  9. Jinkins JR et al: The postsurgical lumbosacral spine. Magnetic resonance imaging evaluation following intervertebral disk surgery, surgical decompression, intervertebral bony fusion, and spinal instrumentation. Radiol Clin North Am. 39(1):1-29, 2001
                                                                                                  10. Ross JS: Magnetic resonance imaging of the postoperative spine. Semin Musculoskelet Radiol. 4(3):281-91, 2000
                                                                                                  11. Stambough JL et al: Subarachnoid drainage of an established or chronic pseudomeningocele. J Spinal Disord. 13(1):39-41, 2000
                                                                                                  12. Saunders RL et al: Four-level cervical corpectomy. Spine. 23(22):2455-61, 1998
                                                                                                  13. McCormack BM et al: Pseudomeningocele/CSF fistula in a patient with lumbar spinal implants treated with epidural blood patch and a brief course of closed subarachnoid drainage. A case report. Spine. 21(19):2273-6, 1996
                                                                                                  14. Aldrete JA et al: Postlaminectomy pseudomeningocele. An unsuspected cause of low back pain. Reg Anesth. 20(1):75-9, 1995
                                                                                                  15. Hosono N et al: Postoperative cervical pseudomeningocele with herniation of the spinal cord. Spine. 20(19):2147-50, 1995
                                                                                                  16. Lee KS et al: Postlaminectomy lumbar pseudomeningocele: report of four cases. Neurosurgery. 30(1):111-4, 1992
                                                                                                  17. Shapiro SA et al: Closed continuous drainage of cerebrospinal fluid via a lumbar subarachnoid catheter for treatment or prevention of cranial/spinal cerebrospinal fluid fistula. Neurosurgery. 30(2):241-5, 1992
                                                                                                  18. Murayama S et al: Magnetic resonance imaging of post-surgical pseudomeningocele. Comput Med Imaging Graph. 13(4):335-9, 1989
                                                                                                  19. Schumacher HW et al: Pseudomeningocele of the lumbar spine. Surg Neurol. 29(1):77-8, 1988
                                                                                                  20. Tuvia J et al: Visualization of a pseudomeningocele on isotope cisternography. Clin Nucl Med. 13(12):889-91, 1988
                                                                                                  21. Teplick JG et al: CT Identification of postlaminectomy pseudomeningocele. AJR Am J Roentgenol. 140(6):1203-6, 1983
                                                                                                  22. Eismont FJ et al: Treatment of dural tears associated with spinal surgery. J Bone Joint Surg Am. 63(7):1132-6, 1981
                                                                                                  23. Helle TL et al: Postoperative cervical pseudomeningocele as a cause of delayed myelopathy. Neurosurgery. 9(3):314-6, 1981