Giant postsurgical pseudomeningocele by SPECT/CT cisternography
Sébastien Dietemann1, Mustapha Benmekhbi, Mohamed Amine Lahlou
1From the *Service de Biophysique et Médecine Nucléaire, †Service de Neurochirurgie, and ‡Service de Radiologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; §ICube, Université de Strasbourg/CNRS UMR 7357; and ║FMTS-Faculté de Médecine, Strasbourg, France.
Abstract:
We describe a case of a 32-year-old man with a giant pseudomeningocele seen on MRI examination 6 months after spinal surgery. Radionuclide SPECT/CT cisternography performed after intrathecal suboccipital injection of In-DTPA identified the site of cerebral spinal fluid leak at the L4 level, and the patient underwent surgical correction of the dural defect. A repeat MRI examination 8 months later showed no signs of recurrence.
Insights
A giant pseudomeningocele after spinal surgery was successfully located using radionuclide SPECT/CT cisternography. Surgical repair of the dural defect resolved the condition, with no recurrence observed on follow-up MRI.
Area of Science:
- Neurosurgery
- Radiology
- Medical Imaging
Background:
- Post-surgical complications can include pseudomeningoceles, which are fluid collections.
- Giant pseudomeningoceles pose diagnostic and management challenges.
Observation:
- A 32-year-old male presented with a giant pseudomeningocele 6 months post-spinal surgery.
- Magnetic Resonance Imaging (MRI) revealed the large pseudomeningocele.
Findings:
- Radionuclide SPECT/CT cisternography pinpointed the cerebrospinal fluid (CSF) leak at the L4 vertebral level.
- Surgical correction of the dural defect was performed.
Implications:
- This case highlights the utility of radionuclide SPECT/CT cisternography in localizing post-surgical CSF leaks.
- Successful surgical intervention led to the resolution of the giant pseudomeningocele and prevented recurrence.
