Cervical giant pseudomeningocele presented with neck pain: conventional MRI and MR myelography findings

Abstract

A 12-year-old boy with neck pain was admitted to our clinic. He had a history of head and neck trauma 3 years before presentation. Laboratory and neurologic examination was unremarkable. Conventional magnetic resonance imaging of cervical spine showed a giant multiloculated cystic lesion with the size of 7.5 cm×2.5 cm. The lesion was hypointense on T1weighted images and hyperintense on T2-weighted images such as cerebrospinal fluid (Fig. 1A, B). The cystic lesion was extending through neural foramens around the spinal nerve roots (Fig. 1C, D). Magnetic resonance myelography demonstrated the pseudomeningocele in detail anterior to spinal cord and thecal sac (Fig. 2). The spinal nerves of cervical and brachial plexus were intact. Conservative management of the lesion was decided because the patient showed no evidence of progressive neurologic deficit. Pseudomeningocele is defined as an extradural collection of cerebrospinal fluid that results from a tear in dura and arachnoid layer. It becomes encapsulated in a fibrous sac. Common etiologic factors are congenital, traumatic, and iatrogenic [1–3]. References