case_images: PMC6826298_01
case_images: T2-weighted magnetic resonance imaging, (a and b) sagittal image showing a high-intensity cyst extending from L4 to S2, (c) axial view demonstrates that the cyst is multilobulated.
case_images: SNI-10-213-g001.jpg
case_images: PMC6826298_01_SNI-10-213-g001.jpg
case_images: F1
case_images: However, the preoperative magnetic resonance imaging (MRI) showed a large/giant pseudomeningocele that extended from L4 to S2 (e.g., total length of 8.9 cm) [Figure 1].
case_images: Intraoperative photographs, (a) a large pseudomeningocele measuring 8.8 in length, (b) the large defect, (c) tight closure of the defect.
case_images: SNI-10-213-g002.jpg
case_images: PMC6826298_01_SNI-10-213-g002.jpg
case_images: F2
case_images: At surgery, the pseudomeningocele sac had an abnormally thick wall that was widely opened [Figure 2a]. After CSF was drained, a protruding rootlet at the depth of the cavity was dissected and maneuvered back into the thecal sac, following by closure of the dural defect [Figure 2b and c].
case_images: Postoperative lumbar magnetic resonance imaging (MRI) showing the success of surgery: MRI, (a) T2-weighted, (b) T1- weighted sagittal image.
case_images: SNI-10-213-g003.jpg
case_images: PMC6826298_01_SNI-10-213-g003.jpg
case_images: F3
case_images: The patient's complaints fully resolved within 1 month, and the MR performed 5 months later demonstrated full resolution of the pseudomeningocele [Figure 3].
case_images: PMC6826298_02
case_images: Lumbar T2-weighted magnetic resonance imaging, (a) sagittal image shows the cyst extending from L1 to L5, note laminectomy of L4, L3, and L2 (b) axial mage.
case_images: SNI-10-213-g004.jpg
case_images: PMC6826298_02_SNI-10-213-g004.jpg
case_images: F4
case_images: The lumbar MRI showed a giant pseudomeningocele extending from L2 to L5; it was 12 cm in length, arising from a defect at the L3-L4 level [Figure 4].
case_images: Intraoperative photograph, note the giant pseudomeningocele, measuring 9.3 cm in length.
case_images: SNI-10-213-g005.jpg
case_images: PMC6826298_02_SNI-10-213-g005.jpg
case_images: F5
case_images: At surgery, the giant sac was opened [Figure 5].