Management of pseudomeningocele following posterior fossa tumor surgery with absence of hydrocephalus: A case report

Background: The management of pseudomeningocele can be challenging and treatment options vary in the literature. There is currently no algorithm or standard protocol regarding the type and timing of treatment. Until now, there has been a little literature and no case report that used puncture techniques as a conservative treatment. We reported the effectiveness of fluid puncture and pressure dressing as an aggressive nonsurgical management of pseudomeningocele. Case presentation: A 5-year-old boy with posterior fossa tumor underwent midline suboccipital craniotomy tumor removal and decompression. A week after the surgery, the patient developed buldging in the operation region. Head CT scan showed pseudomeningocele in suboccipital region, a residual calcified tumor was seen, and no enlargement of ventricle. Conservative management was taken and the patient was managed with fluid puncture and pressure dressing. The reduction in size of the pseudomeningocele appeared within 14 days. Conclusion: Pseudomeningocele is a common complication of posterior fossa surgery. Nonsurgical treatment is the management of choice to reduce the symptoms. Fluid puncture and pressure dressing are effective in reducing symptoms. Surgical intervention is recommended when conservative treatment fails.