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Published in: Child's Nervous System 5/2023

Open Access 21-01-2023 | Magnetic Resonance Imaging | Case Report

Rapid ossification of a giant post-operative occipital pseudomeningocele following posterior fossa surgery

Authors: Daniel Lewis, Chitra Sethuraman, Dimitrios Varthalitis

Published in: Child's Nervous System | Issue 5/2023

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Abstract

Pseudomeningocele formation following posterior fossa surgery is a well-recognised complication, occurring in up to 33% of operated cases in some series. Ossification of a cranial pseudomeningocele is, however, an exceptionally rare event with only three prior reported cases. We present the unique case of a paediatric patient who developed rapid ossification of a giant occipital pseudomeningocele following posterior fossa surgery. An 8-year-old female patient underwent a midline posterior fossa craniotomy for resection of an exophytic brainstem low-grade glioma. Post-surgery, the patient developed pan-ventricular hydrocephalus and a large occipital pseudomeningocele, which initially increased in size despite a successful endoscopic third ventriculostomy (ETV) being performed. At approximately 3 months post-surgery, reduction of the pseudomeningocele was observed with associated prominent ossification of the pseudomeningocele wall on computed tomography (CT) imaging. Surgical excision was subsequently undertaken, and intra-operatively, a large ossified pseudomeningocele was found. Follow-up MRI 1 month later demonstrated almost complete resolution of the pseudomeningocele with an associated reduction in the degree of pan-ventricular ventriculomegaly. This case highlights that ossification of even giant pseudomeningoceles can occur over a time period of just a few months and clinicians should consider ossification whenever a change in size or consistency of a post-operative pseudomeningocele is encountered.
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Metadata
Title
Rapid ossification of a giant post-operative occipital pseudomeningocele following posterior fossa surgery
Authors
Daniel Lewis
Chitra Sethuraman
Dimitrios Varthalitis
Publication date
21-01-2023
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 5/2023
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-023-05829-z

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