Symptomatic postsurgical cerebrospinal fluid leak treated by aspiration and epidural blood patch under ultrasound guidance in 2 adolescents

J Neurosurg Pediatr. 2013 Jan;11(1):87-90. doi: 10.3171/2012.9.PEDS12314. Epub 2012 Oct 26.


Cerebrospinal fluid leakage causing a pseudomeningocele is a well-recognized complication after spine surgery. The repair of pseudomeningocele in a symptomatic patient is usually accomplished with direct open surgical repair of the durotomy, prolonged lumbar drainage, and/or placement of an epidural blood patch. The authors highlight a unique method of pseudomeningocele repair by presenting 2 cases of adolescent girls with symptomatic lumbar pseudomeningoceles. In both cases ultrasound was used to guide the aspiration of CSF from each pseudomeningocele and to apply the epidural blood patch. Both patients had complete and immediate resolution of symptoms. The authors found ultrasound to be a useful tool to assess the extent of the CSF leakage, to determine the degree of aspiration of the extradural CSF, and to confirm the injection of the blood into the epidural space and the space created by the pseudomeningocele.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Blood Patch, Epidural / methods*
  • Cerebrospinal Fluid Leak
  • Cerebrospinal Fluid Rhinorrhea / pathology
  • Cerebrospinal Fluid Rhinorrhea / surgery*
  • Diskectomy
  • Epidural Space / pathology
  • Female
  • Headache / etiology
  • Headache / surgery
  • Humans
  • Intervertebral Disc Degeneration / surgery
  • Laminectomy
  • Magnetic Resonance Imaging
  • Meningocele / surgery
  • Neurosurgical Procedures / methods*
  • Pain, Postoperative / surgery
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / pathology
  • Postoperative Complications / surgery*
  • Suction / methods*
  • Surgery, Computer-Assisted
  • Ultrasonography