Simultaneous Expansion of Pseudomeningocele and Development of Remote Subdural Hygroma: A New Phenomenon

Development of subdural hygroma (SDG) distant from primary neurosurgery is uncommon. We present a rare relationship between remote supratentorial extension of a local SDG and expansion of an infratentorial pseudomeningocele following resection of a cerebellar hemangioblastoma in a 61-year-old female with von Hippel-Lindau disease. Initial Magnetic resonance imaging showed a cystic hemangioblastoma in the right cerebellum with mass effect on the brain stem. The patient undertook median suboccipital craniectomy with duraplasty followed by development of bilateral retrocerebellar SDG and a pseudomeningocele beneath the dural graft. Nineteen days after the operation, a remote SDG appeared supratentorially with concurrent interval growth of the pseudomeningocele. Early management of the growing pseudomeningocele may minimize the occurrence of remote SDG as a post-operative complication.