Postoperative Cerebellar Cyst with Pseudomeningocele After Tumor Removal at the Craniovertebral Junction

Watanabe, Yousuke; Higuchi, Yoshinori; Sunaoka, Hirokazu; Yakufujiang, Maidinamu; Ikegami, Shiro; Iwadate, Yasuo

doi:10.1016/j.wneu.2019.06.197

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…These reports, similarly to ours, concluded that dural defects and small tears in the arachnoid and parenchyma of the cerebellum affect the one-way valve mechanism, causing CSF to accumulate in the cyst. 3,4,8,9 This emphasizes the CSF connection between the pseudomeningocele and the cyst, similar to our case.…”

Section: Discussionsupporting

confidence: 89%

“…Pseudomeningocele formation is mainly from inadequate closure of the dura mater 8 that allows extradural accumulation of CSF and cystic enlargement. 4 There are scarce studies on how pseudomeningocele accumulates CSF within the brain parenchyma. However, since the dura mater was not sutured watertight in this case, postoperative epidural leakage may have been causative; the CSF that accumulated subcutaneously due to the one-way valve effect probably formed the pseudomeningocele.…”

Section: Discussionmentioning

confidence: 99%

“…While pseudomeningocele can be symptom-atic, causing cosmetic problems, meningitis, or compression of the brain/nerve tissue, most cases are asymptomatic. 3 Postoperative cyst formation in the brain parenchyma is a rare complication, 4 particularly in the cerebellum, and the formative mechanism is unknown. Here, we report a case of life-threatening cerebellar cyst formation after foramen magnum meningioma removal in which a pseudomeningocele in the posterior neck area formed postoperatively and appeared to associate with cyst formation.…”

Section: Introductionmentioning

confidence: 99%

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Symptomatic Cerebellar Cyst Formation after Foramen Magnum Meningioma Removal: A Case Report

Hanai,

Yanaka,

Onuma

et al. 2024

Asian J Neurosurg

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Background Symptomatic cerebellar cyst formation after surgery is rare and the mechanism remains unknown. We describe a cerebellar cyst that gradually expanded, becoming symptomatic, after the removal of a foramen magnum meningioma and discuss the mechanism of cyst formation. Case Description A 76-year-old woman with a tumor at the foramen magnum was treated by posterior fossa craniotomy and C1 hemilaminectomy. The patient suddenly developed cerebellar symptoms and consciousness disturbance approximately 1 week into an otherwise good postoperative course. Imaging showed a subcutaneous pseudomeningocele in the occipital region and cerebellar cyst formation. After resolution by fenestration of the cerebellar cyst and duraplasty, the patient's symptoms gradually improved. No tumor or cerebellar cyst recurrence has been detected in over 5 years since the surgery. Conclusion Postoperative pseudomeningocele appeared crucial for cerebellar cyst formation. Postoperative development of symptomatic cerebellar cysts is rare but should be recognized as a serious, sometimes life-threatening, postoperative complication of posterior fossa surgery.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Symptomatic Cerebellar Cyst Formation after Foramen Magnum Meningioma Removal: A Case Report

Hanai,

Yanaka,

Onuma

et al. 2024

Asian J Neurosurg

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“…Prevention is an important point that is often overlooked in the treatment of pseudomeningocele. Water-tight closure of the dura should always be attempted, and keep bleeding to a minimum so as not to interfere with CSF flow [13] . The use of certain materials and techniques for suturing the dura showed inconsistent results.…”

Section: Clinical Discussionmentioning

confidence: 99%

Management of pseudomeningocele following posterior fossa tumor surgery with absence of hydrocephalus: A case report

Dustur

Parenrengi

Suryaningtyas

2022

International Journal of Surgery Case Reports

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“…Posterior fossa surgeries are done in variety of pathologies like cerebellopontine tumor, microvascular decompression, Arnold chiari malformation, medulloblastoma etc. 1 Pseudomeningocele is the abnormal collection of CSF at the operative site following the cranial or spinal surgery. It may be due to the improper closure of dura or when CSF fills the potential space created during the surgery.…”

Section: Introductionmentioning

confidence: 99%

Postoperative posterior fossa pseudomeningocele: risk factors and management strategies

et al. 2019

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Background: Pseudomeningocele is a considerable morbidity after posterior fossa surgery. Its incidence and optimal management strategies are quite unclear. Hence the objective of this study is to define the risk factors and evaluate the management strategies and to study the incidence and morbidity of postoperative posterior fossa pseudomeningocele.Methods: A retrospective study of 33 patients undergone posterior fossa surgery for variety of diseases in the department of neurosurgery, Saveetha Medical College and Hospital from January 2015 to December 2018 with emphasis on incidence of pseudomeningocele,its morbidity and treatment strategies.Results: Out of 33 posterior fossa surgeries performed, 9 developed pseudomeningocele. Hence the incidence of pseudomeningocele in hospital is 27.27%. Out of 9 patients who developed pseudomeningocele, 6 patients were symptomatic, and aspiration was done to 5 patients and one patient underwent resurgery. That one patient underwent subgaleal-peritoneal shunt, excision of recurrent tumor was performed after which the symptoms subsided.Conclusions: Psudomeningocele is a well-known complication of posterior fossa surgery. The risk factors for pseudomeningocele formation after posterior fossa surgery has been evaluated. Age, sex and type of surgery are found to be a risk factors in our study. Conservative management is effective in most cases to reduce the symptoms. Surgical intervention is advocated, only when conservative treatment fails. Preventive measures like careful perioperative planning, strict adherence to aseptic techniques, usage of autologous pericranium with dural sealant augmentation, polyethylene glycol hydrogel dural sealant can be adopted.

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Postoperative Cerebellar Cyst with Pseudomeningocele After Tumor Removal at the Craniovertebral Junction

Cited by 6 publications

References 7 publications

Symptomatic Cerebellar Cyst Formation after Foramen Magnum Meningioma Removal: A Case Report

Symptomatic Cerebellar Cyst Formation after Foramen Magnum Meningioma Removal: A Case Report

Management of pseudomeningocele following posterior fossa tumor surgery with absence of hydrocephalus: A case report

Postoperative posterior fossa pseudomeningocele: risk factors and management strategies

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