• Claudio De Tommasi and Aaron E Bond.
• Department of Neurosurgery, Christchurch Public Hospital, Christchurch Central, Christchurch, New Zealand. Electronic address: claudio.detommasi@cdhb.health.nz.
• World Neurosurg. 2016 Apr 1; 88: 688.e1-688.e7.

BackgroundPseudomeningocele is a recognised complication after posterior fossa decompression for Chiari malformation. Its management can be challenging and treatment options vary in literature.Case DescriptionA difficult-to-treat case of a pseudomeningocele after posterior fossa decompression for a Chiari I malformation is presented. A 34-year-old woman underwent an initial decompression followed by multiple revision surgeries after the development of a symptomatic pseudomeningocele and a low-grade infection. Complications associated with standard treatment modalities, including lumbar drainage and dural repair, are discussed. A review of the existing literature is presented.ConclusionsThe reported case ultimately required complete removal of all dural repair materials to eliminate the patient's low-grade infection, a muscular flap, and placement of a ventricular-peritoneal shunt for definitive treatment after a trial of a lumbar drain led to herniation and development of a syrinx.Copyright © 2016 Elsevier Inc. All rights reserved.

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