RETROPHARYNGEAL PSEUDOMENINGOCELE AFTER ATLANTOOCCIPITAL DISLOCATION - REPORT OF 2 CASES

OBJECTIVE AND IMPORTANCE: We report two cases of retropharyngeal pseud omeningocele after atlanto-occipital dislocation. This is rare, with o nly one other reported case in the literature. CLINICAL PRESENTATION: We report two patients who presented after blunt cervical and head tra uma. Plain films revealed that each patient had atlanto-occipital disl ocation. Subsequent magnetic resonance imaging revealed the delayed de velopment of retropharyngeal pseudomeningocele. Concomitant hydrocepha lus was noted in both patients. INTERVENTION: The surviving patient sh owed marked neurological improvement and resolution of his pseudomenin gocele after ventriculoperitoneal shunting. CONCLUSION: For patients w ith closed head injuries who develop posttraumatic pseudomeningocele, we recommend cranial computed tomography to assess for the presence of hydrocephalus. In patients with atlanto-occipital dislocation, delaye d neurological deterioration warrants magnetic resonance imaging of th e craniocervical junction to rule out posttraumatic pseudomeningocele.