Delayed Development of a Giant Cranial Pseudomeningocele After Surgical Excision of a Parasagittal Meningioma: A Case Report

Pseudomeningoceles are among the most common postoperative neurosurgical complications, usually presenting in the early postoperative period and often responding well to nonsurgical management. Here, we present a case of a giant cranial pseudomeningocele that developed three years after parasagittal meningioma resection, without any known risk factors. Despite conservative measures, the pseudomeningocele grew significantly over two years, reaching 22 cm along its long axis. Immediate surgical management was necessary to address the underlying cause of the pseudomeningocele, alleviate the patient's discomfort, and restore her cosmesis. The pseudomeningocele, along with the redundant skin, was excised, followed by dural defect repair and cosmetic skin closure. The patient recovered well postoperatively. This case highlights the need for close follow-up of patients undergoing medical management for pseudomeningocele and timely adoption of surgical management when necessary.