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Unusual Case of Multiple Posttraumatic Lumbar Intraspinal Pseudomeningoceles: CT, MR and Clinical Features 2004

Burgos, Ricardo, M.D., Phillips, C. Douglas, M.D.

Unlike the brachial plexus, the lumbar and sacral plexi are deep and relatively immobile. Therefore, posttraumatic lumbosacral nerve root avulsions and nerve sheath tears leading to the formation of pseudomeningoceles are uncommon. When posttraumatic pseudomeningoceles occur, they are typically foraminal and/or extraspinal. We present a case of multiple posttraumatic intraspinal pseudomeningoceles at the lumbar level. The patient sustained multiple traumatic injuries, including sacroiliac joint separation and multiple lumbar transverse process fractures after a motor vehicle accident. He lost motor and sensory function in his lower extremity, which persisted on follow up 13 month s after the injury, when lumbar spine MRI demonstrated multiple intraspinal pseudomeningoceles. Key imaging findings of emergent and follow up studies, as well as clinical features are emphasized.