The Life and Trials of a Pseudomeningocoele

This case study introduces Ms Z. It discusses her story and the nursing care of her journey with a diagnosis of a pseudomeningocele. This case study was developed using direct interviews with the patient, discussions with the patient’s surgeon, research articles, viewing scans, photos and using the patient’s clinical notes. The patient’s journey with the pseudomeningocele spans over a 20 year period with many up’s and downs throughout, resulting with what is hoped to be a better quality of life.

Ms Z’s symptoms started at the age of sixteen. She experienced severe headaches when she coughed or laughed and was seen by a neurologist at the time but no clear diagnosis was made. Her symptoms continued and after multiple medical appointments, a diagnosis of Chiari Malformation was made. She had her first surgery in 2013 after which Ms Z reported her complications began to occur. She moved to New Zealand and started to get more unwell and presented to a rural emergency department (ED). She has undergone multiple procedures in New Zealand including long term intravenous (IV) antibiotics resulting from an infection previously undiagnosed. Nursing considerations will be discussed throughout the case study including peri and postoperative care for neurosurgical patients with pseudomeningoceles, complications to be aware of, and holistic support for patients - physical, emotional and psychological.