Subdural fluid collection rather than meningitis contributes to hydrocephalus after cervical laminoplasty: A case report

Figure 1 Previous imaging data at a local hospital. A: Sagittal T2-weighted cervical magnetic resonance (MR) image before laminoplasty surgery revealing cervical spinal stenosis; B: Axial T2-weighted MR image before laminoplasty surgery showing a normal ventricle; C and D: Sagittal T2-weighted MR image showing obvious cerebrospinal fluid leakage without subdural fluid collection at 1 and 8 mo after cervical laminoplasty; E: Cervical MR image at 9 mo after laminoplasty surgery demonstrating a cystic lesion around the cervical spinal cord and medulla oblongata; F: Head computed tomography scan at 9 mo after cervical laminoplasty revealed hydrocephalus with marked enlargement of the ventricular system without any occupying lesion.

Figure 2 Imaging examination and treatment at our hospital. A: Computed tomography myelography revealing that the defect of dural-arachnoid was located at the C5 level and close to the lower edge of the fixed plate; B: Sagittal and axial view of cervical magnetic resonance imaging before pseudomeningocele drainage; C: Sagittal and axial view after pseudomeningocele drainage revealing a significant decrease in the cystic volume; D: The patient undergoing pseudomeningocele drainage; E: Intraoperative photograph demonstrating the dural-arachnoid defect; F: Dural-arachnoid defect was repaired with autologous fascia.

Figure 3 Cervical magnetic resonance imaging and brain computed tomography in follow-up period. A: Cervical magnetic resonance imaging at 2 d after dural repair showing significantly deceased pseudomeningocele and subdural fluid collection; B: Subdural fluid collection disappeared completely 15 mo after dural repair; C: Computed tomography-scan at 3 mo after dural repair demonstrated reduced hydrocephalus compared with pre-operation; D: Brain magnetic resonance at 1 year after dural repair showed that the ventricular system almost returned to normal shape.