POSTOPERATIVE CERVICAL PSEUDOMENINGOCELE WITH HERNIATION OF THE SPINAL-CORD

Study Design. This is a report of a patient in whom spinal cord hernia tion into a pseudomeningocele resulted in progressive myelopathy. Obje ctive. To describe the outcome of a 59-year-old man who visited Osaka University Hospital complaining of gait disturbance. He had undergone cervical laminectomy to resect a spinal cord tumor 14 years previously . Summary of Background Data. Pseudomeningocele is an extremely rare c ondition and can be overlooked. In addition, cord herniation into the pseudomeningocele rarely can be diagnosed before surgical exploration. Our patient represents the first case we are aware of in which magnet ic resonance imaging could clearly demonstrate not only the pseudomeni ngocele, but the herniation of the cord into the cyst. Methods. Magnet ic resonance imaging was used for preoperative acid postoperative inve stigation. Results. The pseudomeningocele was resected to improve the neurologic status of the patient. During the operation, the herniated cord was successfully reduced into the original subarachnoid space by the release of adhesion. Most symptoms subsided soon after surgery. Ma gnetic resonance imaging could delineate not only the cyst and cord he rniation, but the medullary pathology. The distribution of high-intens ity areas on T2-weighted images suggested the cord damage. Conclusion. Magnetic resonance imaging revealed not only the cyst and cord hernia tion, but medullary pathology, too.