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<p>We present a rare case of right brachial plexus traction injury with the subsequent development of a large symptomatic pseudomeningocele presenting with progressive cervical swelling and ipsilateral Horner’s syndrome. Our patient is a 17-year-old adolescent who experienced a fall during recreational rock climbing. While initial neuroimaging appeared unremarkable, the patient developed progressive swelling in the right supraclavicular region after 7&#xa0;days of the trauma, and then complete paralysis of the ipsilateral upper extremity and Horner’s syndrome. Magnetic resonance imaging (MRI) revealed an extensive cerebrospinal fluid-filled collection along the T1/2 neural foramen, thus forming a pseudomeningocele measuring 11.3&#xa0;cm in diameter. In consideration of the progressive cerebrospinal fluid leakage and potential risk of spinal cord herniation, we performed surgical exploration through a posterior approach and repaired a 1-cm dural defect with active cerebrospinal fluid leakage using 5–0 Prolene sutures. Postoperative MRI at 1&#xa0;week showed nearly full resolution of the pseudomeningocele, with minimal residual fluid collection. This case underscores the critical importance of prompt recognition of pseudomeningocele formation in traumatic brachial plexus injuries, particularly when patients present with progressive cervical swelling. Timely surgical intervention can lead to excellent outcomes in these challenging cases.</p>

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Giant Cervical Pseudomeningocele Following Traumatic Brachial Plexus Traction Injury: A Case Report

  • 期刊论文

  • 发表日期：

    2025年6月25日

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  • Jun Chen,
  • Chun Zhou,
  • Lunshan Xu,
  • Tianzun Li

摘要

We present a rare case of right brachial plexus traction injury with the subsequent development of a large symptomatic pseudomeningocele presenting with progressive cervical swelling and ipsilateral Horner’s syndrome. Our patient is a 17-year-old adolescent who experienced a fall during recreational rock climbing. While initial neuroimaging appeared unremarkable, the patient developed progressive swelling in the right supraclavicular region after 7 days of the trauma, and then complete paralysis of the ipsilateral upper extremity and Horner’s syndrome. Magnetic resonance imaging (MRI) revealed an extensive cerebrospinal fluid-filled collection along the T1/2 neural foramen, thus forming a pseudomeningocele measuring 11.3 cm in diameter. In consideration of the progressive cerebrospinal fluid leakage and potential risk of spinal cord herniation, we performed surgical exploration through a posterior approach and repaired a 1-cm dural defect with active cerebrospinal fluid leakage using 5–0 Prolene sutures. Postoperative MRI at 1 week showed nearly full resolution of the pseudomeningocele, with minimal residual fluid collection. This case underscores the critical importance of prompt recognition of pseudomeningocele formation in traumatic brachial plexus injuries, particularly when patients present with progressive cervical swelling. Timely surgical intervention can lead to excellent outcomes in these challenging cases.