An unusual stab wound causing a traumatic pseudomeningocele at the craniocervical junction

A stab wound to the craniocervical junction complicated by a pseudomeningocele has been reported rarely. A 65-year-old man was stabbed with a knife, and the blade penetrated the space between the occipital bone and the atlas. On admission, he presented with quadriparesis: the left arm was predominantly affected. The sensory level was at C2 on the left side. T2-weighted MRI showed a focal area of hyperintensity at the cervicomedullary junction, localized to the left of the spinal cord. The wound was carefully cleaned and closed. Follow-up MRI revealed a large pseudomeningocele along the trajectory, which resorbed completely without intervention. The quadriparesis improved progressively, except for the left arm, which improved only slightly. The asymptomatic insignificant meningocele completely improved spontaneously without surgery. (C) 2009 Elsevier Ltd. All rights reserved.