title: Cervical pseudomeningocele due to occult hydrocephalus.
abstract: METHODS
  Case report with a brief review of the literature.
  
  
  OBJECTIVE
  To describe a rare clinical presentation of post-traumatic hydrocephalus (PTH) in a child who sustained a complete cervical spinal cord injury (SCI).
  
  
  BACKGROUND
  The incidence of PTH can be as high as 30% in cases of pediatric SCI and traumatic brain injury. Presentation may include gait disturbance, altered mental status, or incontinence. To our knowledge, this is the first documentation of PTH presenting as a postsurgical pseudomeningocele.
  
  
  METHODS
  An 8-year-old girl involved in a motor vehicle accident sustained a C2-C3 fracture dislocation resulting in a complete SCI. She was initially treated with C2-C3 sublaminar wiring and halo placement. At postoperative week 6, the patient underwent drainage of a posterior cervical pseudomeningocele and repair of a small dural leak at C2-C3. She subsequently exhibited signs of altered mental status, and computed tomography scan revealed a significant hydrocephalus.
  
  
  RESULTS
  Emergent ventriculostomy was performed, and was converted to a ventriculo-peritoneal shunt 2 days later. The patient's neurologic status markedly improved, and she continues to do well at 2 months after surgery.
  
  
  CONCLUSIONS
  PTH presenting as a pseudomeningocele is extremely rare. In a patient with polytrauma and concomitant traumatic brain injury, the spine surgeon should consider hydrocephalus as a potential cause for a postsurgical pseudomeningocele, even several months after initial injury.
authors.affiliation: Albert Einstein Medical Center, Philadelphia, PA, USA.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Pahys
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Chicorelli
authors.forename: Jahangir
authors.initials: J
authors.lastname: Asghar
authors.forename: Randal R
authors.initials: RR
authors.lastname: Betz
authors.forename: Amer F
authors.initials: AF
authors.lastname: Samdani
mesh_terms: D000063:Accidents, Traffic; D001930:Brain Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D004204:Joint Dislocations / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008588:Meningocele / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D013119:Spinal Cord Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D016103:Spinal Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D013123:Spinal Fusion; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt; D014696:Ventriculostomy