Document Detail


Cervicothoracic intraspinal pseudomeningocele with cord compression after a traumatic brachial plexus injury.
MedLine Citation:
PMID:  20869921     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND CONTEXT: Pseudomeningoceles are noted within the neural foramen after avulsion plexus injuries. We present the case of a cervicothoracic epidural pseudomeningocele with spinal cord compression 18 years after a brachial plexus injury.
PURPOSE: To present a case report of a patient and literature review on cases with epidural pseudomeningoceles.
STUDY DESIGN: Case report and review of the literature.
METHODS: Retrospective review of the medical records of a patient presenting with an epidural pseudomeningocele after a plexus injury.
RESULTS: A 37-year-old male presented with neurological decline 18 years after sustaining a brachial plexus injury. Magnetic resonance tomography revealed an epidural fluid collection from C5 to T7 with significant spinal cord compression. Surgical intervention initially involved fenestration of the cyst and then rhizotomies of the C7 and C8 roots resulting in resolution of his new symptoms.
CONCLUSIONS: Pseudomeningoceles are common after brachial plexus avulsion injury and are usually stable, causing no symptoms, other than plexus neuropathies. We are unaware of previous reports of a patient with a traumatic brachial plexus avulsion who developed a large cervicothoracic, symptomatic, spinal, epidural, intracanalicular pseudomeningocele with cord compression 18 years after the initial injury. Patients with prior trauma and known plexus injuries with development of new neurological symptoms should be evaluated for the rare case of intradural pseudomeningoceles. Preoperative imaging with computed tomography myelography is important to isolate and definitively treat the fistulous connection.
Authors:
Dan M Drzymalski; Jayshree Tuli; Ning Lin; Sagun Tuli
Publication Detail:
Type:  Journal Article     Date:  2010-09-25
Journal Detail:
Title:  The spine journal : official journal of the North American Spine Society     Volume:  10     ISSN:  1878-1632     ISO Abbreviation:  Spine J     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130732     Medline TA:  Spine J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Harvard Medical School, Boston, MA 02115, USA.
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