Retropharyngeal pseudomeningocele after atlanto-occipital dislocation: report of two cases
1Department of Neurosurgery, Medical University of South Carolina, Charleston, USA.
Objective And Importance:
We report two cases of retropharyngeal pseudomeningocele after atlanto-occipital dislocation. This is rare, with only one other reported case in the literature.
Clinical Presentation:
We report two patients who presented after blunt cervical and head trauma. Plain films revealed that each patient had atlanto-occipital dislocation. Subsequent magnetic resonance imaging revealed the delayed development of retropharyngeal pseudomeningocele. Concomitant hydrocephalus was noted in both patients.
Intervention:
The surviving patient showed marked neurological improvement and resolution of his pseudomeningocele after ventriculoperitoneal shunting.
Conclusion:
For patients with 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, delayed neurological deterioration warrants magnetic resonance imaging of the craniocervical junction to rule out posttraumatic pseudomeningocele.