Pediatric Avulsion Pseudomeningocele

  • Etiology: Brachial plexus birth injury consisting of downward traction on shoulder girdle during vaginal birth = shoulder dystocia
  • Imaging:
  • DDX:
  • Complications: Leads to permanent nerve dysfunction and muscle weakness and skeletal changes
  • Treatment:
  • Clinical:
    — Erb palsy – injury to C5-6 or C5-7
    — Lose shoulder abduction and external rotation
    — Lose elbow flexion and forearm pronation
    — When C7 out lose wrist extension
    — Waiter Tip Deformity (shoulder adducted and internally rotated, elbow extended, wrist flexed)

Radiology Cases of Avulsion Pseudomeningocele

MRI of avulsion pseudomeningocele
Sagittal (left) and axial (right) T2 MRI without contrast of the cervical spine shows a left sided extradural CSF collection posterior to the spinal cord from C6 to T1.