Post Surgical Pseudomeningocele in a Patient with Cervical Neurinoma; a case report and review of the literature

Our patient was a 43-year-old woman with a suboccipital headache and pain in the upper cervical region from 3 years ago with a progressive generalized weakness in the last 3 months. Neuroimaging study showed a dumbell shaped lesion with compression of the spinal cord in the cervical region that was identified as a neurinoma. The tumor had been completely removed by surgery but after the operation, site of surgery bulged and consequently the patient was reevaluated. The bulging was diagnosed as a pseudomeningocele that did not response to conservative management and was removed surgically. Possible causes for the development of post operative pseudomeningocele can be soft tissues and paravertebral muscles damage or high intradural pressures that cause leakage of cerebrospinal fluid from a very small dural defect. Shunt insertion should be reserved for patients with impaired cerebrospinal fluid absorption or those with a refractory fistula despite medical therapies and direct surgical repairs.