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Article
November 1980

Positional Headache and Syncope Associated With a Pseudomeningocele

Author Affiliations

343 W Houston No. 101 San Antonio, TX 78205
New York University Medical Center Department of Neurosurgery 550 First Ave New York, NY 10016

Arch Neurol. 1980;37(11):736-737. doi:10.1001/archneur.1980.00500600084022
Abstract

To the Editor.—  We studied an unusual complex of symptoms that was coincident with a pseudomeningocele one year after operation for diastematomyelia.

Report of a Case.—  Diastematomyelia was identified in a 14-year-old girl who had had urinary frequency and sacral pain. The bony spur was removed and associated lipoma transsected where it entered the cord substance. A Silastic dural substitute was sutured over the area of the dural opening. Postoperatively, a small pseudomeningocele was treated with aspiration and local pressure. Within a few weeks, it seemed to resolve.Four months later, she complained of intermittent suboccipital headaches, which always occurred when she was upright, and occasional syncopal episodes when she assumed the upright position. The symptoms remitted spontaneously, only to recur eight months later. They were clearly positional. The headache only occurred and was constant when the patient was upright. It was quickly relieved when she reclined into the recumbent

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