Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development
Atlantooccipital dislocation can be complicated by a traumatic durotomy that may lead to the rare development of a retropharyngeal pseudomeningocele. To our knowledge this has been reported only five times previously. We present the case of a 60-year-old man involved in a motor vehicle accident who...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2015/361764 |
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| author | Robert S. Qiu Mina G. Safain Max Shutran Alejandra M. Hernandez Steven W. Hwang Ron I. Riesenburger |
| author_facet | Robert S. Qiu Mina G. Safain Max Shutran Alejandra M. Hernandez Steven W. Hwang Ron I. Riesenburger |
| author_sort | Robert S. Qiu |
| collection | DOAJ |
| description | Atlantooccipital dislocation can be complicated by a traumatic durotomy that may lead to the rare development of a retropharyngeal pseudomeningocele. To our knowledge this has been reported only five times previously. We present the case of a 60-year-old man involved in a motor vehicle accident who suffered an atlantooccipital dislocation and C5-C6 three-column injury. A unique MRI image of a defect in the ventral dura posterior to C2 was appreciated. He underwent occiput to T2 internal fixation and arthrodesis. During surgery, CSF egress was seen caudal to the right C2 nerve root. A DuraMatrix onlay patch reinforced with DuraSeal was placed to stop the CSF leak. A lumbar subarachnoid drain was also placed. The patient made a satisfactory recovery with residual mild weakness of his right upper extremity. In this report, we demonstrate that careful MRI review can reveal a ventral durotomy in a traumatic atlantooccipital dislocation and, if discovered, effective treatment including a lumbar subarachnoid drain for CSF diversion may prevent progression to a retropharyngeal pseudomeningocele. The literature on this rare presentation and associated durotomy is provided. |
| format | Article |
| id | doaj-art-a24a7b51f5a142f79237151516ea984b |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-a24a7b51f5a142f79237151516ea984b2025-02-03T05:46:12ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/361764361764Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele DevelopmentRobert S. Qiu0Mina G. Safain1Max Shutran2Alejandra M. Hernandez3Steven W. Hwang4Ron I. Riesenburger5Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, MA 02111, USADepartment of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, MA 02111, USADepartment of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, MA 02111, USADepartment of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, MA 02111, USADepartment of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, MA 02111, USADepartment of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, MA 02111, USAAtlantooccipital dislocation can be complicated by a traumatic durotomy that may lead to the rare development of a retropharyngeal pseudomeningocele. To our knowledge this has been reported only five times previously. We present the case of a 60-year-old man involved in a motor vehicle accident who suffered an atlantooccipital dislocation and C5-C6 three-column injury. A unique MRI image of a defect in the ventral dura posterior to C2 was appreciated. He underwent occiput to T2 internal fixation and arthrodesis. During surgery, CSF egress was seen caudal to the right C2 nerve root. A DuraMatrix onlay patch reinforced with DuraSeal was placed to stop the CSF leak. A lumbar subarachnoid drain was also placed. The patient made a satisfactory recovery with residual mild weakness of his right upper extremity. In this report, we demonstrate that careful MRI review can reveal a ventral durotomy in a traumatic atlantooccipital dislocation and, if discovered, effective treatment including a lumbar subarachnoid drain for CSF diversion may prevent progression to a retropharyngeal pseudomeningocele. The literature on this rare presentation and associated durotomy is provided.http://dx.doi.org/10.1155/2015/361764 |
| spellingShingle | Robert S. Qiu Mina G. Safain Max Shutran Alejandra M. Hernandez Steven W. Hwang Ron I. Riesenburger Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development Case Reports in Surgery |
| title | Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development |
| title_full | Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development |
| title_fullStr | Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development |
| title_full_unstemmed | Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development |
| title_short | Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development |
| title_sort | early identification of traumatic durotomy associated with atlantooccipital dislocation may prevent retropharyngeal pseudomeningocele development |
| url | http://dx.doi.org/10.1155/2015/361764 |
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