title: Surgical management of chronic traumatic pseudomeningocele of the craniocervical junction: case report.
abstract: OBJECTIVE
  Chronic traumatic pseudomeningocele (PM) is a rare complication of gunshot injuries of the craniocervical junction in pediatric patients. Impairment of the CSF dynamics may cause severe symptoms and should be treated.
  
  
  METHODS
  We report the case of a 6-year-old girl who was accidentally shot in the neck during tribal clashes. On being admitted, she was neurologically intact with cerebrospinal fluid (CSF) leakage through the wounds. She underwent primary closure of the wounds in a rural medical facility. After two episodes of meningitis, CSF leakage resolved spontaneously. Nine months later, the patient was presented with a disfiguring mass growing in the posterior neck, severe headaches, and constitutional symptoms such as loss of appetite and a failure to thrive.
  
  
  RESULTS
  Neurosurgical intervention was performed with the patient in the prone position. Occipital pericranium graft was used to repair the defect, and the cavity of the PM was obliterated with muscle layers. The patient's symptoms improved at 1 year follow-up without PM recurrence.
  
  
  CONCLUSIONS
  This is a rare presentation of gunshot injuries in an environment with limited neurosurgical resources. Restoring the normal pattern of CSF circulation should be the aim of any neurosurgical intervention.
authors: Department of Neurosurgery, Institute of Neurosciences, Hospital Clínico San Carlos, Prof. Martín Lagos s/n, 28040, Madrid, Spain, josue.avecillas@salud.madrid.org.
authors: Josué M
authors: JM
authors: Avecillas-Chasin
authors: Mwanabule
authors: M
authors: Ahmed
authors: Eric
authors: E
authors: Robles Hidalgo
authors: Luis
authors: L
authors: Gómez-Perals
mesh_terms: D002648:Child; D004677:Encephalocele / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008588:Meningocele / Q000209:etiology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D015898:Tomography Scanners, X-Ray Computed; D014948:Wounds, Gunshot / Q000150:complications