Case contributed by Ammar Haouimi
Diagnosis almost certain


Left frontal swelling. Had surgery for left frontal tumor 6 years prior (partial resection).

Patient Data

Age: 40 years
Gender: Male

Well-circumscribed broad-based left frontal extra-axial mass, isointense to the cortical grey matter on both T1, T2, and hyperintense on FLAIR with no restricted diffusion. A "CSF cleft sign" is noted around the mass on coronal T2, indicating its extra-axial location. No calcification seen on GE. The postcontrast sequences show a vivid homogeneous enhancement with a dural tail sign.

Left frontal cystic cavity of CSF signal on all sequences with surrounding gliosis, communicating with the adjacent subarachnoid spaces and extending through the craniotomy defect in keeping with pseudomeningocele.

Small vessel ischemic changes are noted.

Case Discussion

MRI features of an iatrogenic pseudomeningocele in a patient with a history of surgery for left frontal meningioma (partial resection).

Pseudomeningocele is defined as an abnormal collection of cerebrospinal fluid (CSF) that occurs due to leakage from the CSF-filled spaces surrounding the brain and/or spinal cord as a result of trauma or surgery. 

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