EXTRAPLEURAL INTRATHORACIC APICAL TRAUMATIC PSEUDOMENINGOCELE

A large traumatic pseudomeningocele appeared in a 19 year old man following a trauma which resulted in a fracture of the right first rib, separation of the lateral aspect of the D-7—T-1 disk, and a dural tear at that level. Fluid collected in the extrapleural space overlying the lung apex, and pantopaque entered and passed out of this cavity freely. Prior to myelography the cerebrospinal fluid was grossly bloody, but returned to a clear, colorless state 10 days later. This communication closed off, and the apical accumulation of cerebrospinal fluid has not reappeared over a 2 year period. Surgery was contraindicated

In contrast to the few instances of traumatic arachnoidopleural fistulae, the present patient had an extrapleural rather than an intrapleural communication. This is unique, inasmuch as we have been unable to find a similar situation in a review of the literature.

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				V. Sarwal, R. K. Suri, O. P. Sharma, A. Baruah, P. Singhi, S. Gill, and J. R. Bapuraj Traumatic Subarachnoid-Pleural Fistula Ann. Thorac. Surg., December 1, 1996; 62(6): 1622 - 1626. [Abstract] [Full Text]