PMC6826298_01
T2-weighted magnetic resonance imaging, (a and b) sagittal image showing a high-intensity cyst extending from L4 to S2, (c) axial view demonstrates that the cyst is multilobulated.
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F1
However, the preoperative magnetic resonance imaging (MRI) showed a large/giant pseudomeningocele that extended from L4 to S2 (e.g., total length of 8.9 cm) [Figure 1].
Intraoperative photographs, (a) a large pseudomeningocele measuring 8.8 in length, (b) the large defect, (c) tight closure of the defect.
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F2
At surgery, the pseudomeningocele sac had an abnormally thick wall that was widely opened [Figure 2a]. After CSF was drained, a protruding rootlet at the depth of the cavity was dissected and maneuvered back into the thecal sac, following by closure of the dural defect [Figure 2b and c].
Postoperative lumbar magnetic resonance imaging (MRI) showing the success of surgery: MRI, (a) T2-weighted, (b) T1- weighted sagittal image.
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F3
The patient's complaints fully resolved within 1 month, and the MR performed 5 months later demonstrated full resolution of the pseudomeningocele [Figure 3].
PMC6826298_02
Lumbar T2-weighted magnetic resonance imaging, (a) sagittal image shows the cyst extending from L1 to L5, note laminectomy of L4, L3, and L2 (b) axial mage.
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F4
The lumbar MRI showed a giant pseudomeningocele extending from L2 to L5; it was 12 cm in length, arising from a defect at the L3-L4 level [Figure 4].
Intraoperative photograph, note the giant pseudomeningocele, measuring 9.3 cm in length.
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F5
At surgery, the giant sac was opened [Figure 5].