RESUMO
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.
RESUMO
Main management for the frontal sinus fracture is using the pericranial flap. Pericranial flaps based on the supraorbital and supratrochlear vasculature have previously been used with significant success for the separation of intracranial and extracranial spaces after major trauma. Defect closure was modified due to lack of the frontal periosteum; the graft was made from the temporal side of periosteum to make primary periosteal flap longer. Defect closure could be optimum. Evaluation for 6 months showed a significant improvement without major complications. In this article, we propose a new modification technique as one of promising alternatives.
