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Images in Neurology |

Pseudomeningocele and Traumatic Brain Lesion Following Vacuum Extraction Delivery

Thomas Kau, MD; Herwig Scharfegger, MD; Johann Gasser, MD; Klaus A. Hausegger, MD
Arch Neurol. 2007;64(7):1048-1049. doi:10.1001/archneur.64.7.1048.
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A true meningocele represents 1 type of neural tube defect that is caused by failure of the surface ectoderm to separate from the neuroectoderm early in embryonic development. This results in a bony defect of the skull, allowing herniation of the meninges (meningocele) and brain tissue (encephalocele). Meningoencephaloceles, however, rarely occur at the anterior fontanelle.1 Sporadic reports exist on leptomeningeal cysts due to vacuum extraction, which are predominantly located over the anterior fontanelle.2

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Magnetic resonance images of a 15-day-old male infant. T2-weighted sagittal images (A and C) depict a large, frontally located cystic formation communicating with the extraventricular liquor space via the anterior fontanelle. Gyral cortical structures appear in the posterior part of this pseudomeningocele in the T2-weighted sagittal image (A, arrow) and in the T1-weighted spin-echo transversal image (B, arrow). The superior frontal gyrus shows a corresponding, predominantly right paramedian defect (C, arrow).

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