Conservative vs Interventional Management of Postsurgical CSF Pseudomeningocele (PSEUDO)

May 22, 2026 updated by: Norbert Svoboda, Charles University, Czech Republic

Conservative Versus Interventional Management of Postsurgical CSF Pseudomeningocele: A Randomized Controlled Trial

Dear Sir or Madam,

You have been invited to participate in a clinical study whose aim is to compare the effectiveness of two different approaches to the treatment of cerebrospinal fluid (CSF) pseudomeningocele - conservative management and interventional treatment (surgical or drainage procedures). CSF pseudomeningocele is a complication that may occur after brain surgery and is characterized by an accumulation of cerebrospinal fluid beneath the skin. At present, there is no clear consensus regarding the optimal treatment approach.

How the study will be conducted

After enrollment in the study, you will be randomly assigned (by chance) to one of two groups:

Conservative management: no surgical intervention, regular follow-up, and wound care.

Interventional treatment: simple aspiration/puncture, insertion of a lumbar drain, or reoperation.

During the study, you will be followed for a period of 1 year. Follow-up examinations will include clinical assessment and brain imaging (CT or MRI) at 4 months and 12 months after enrollment.

Risks associated with the interventional group Simple cyst aspiration/puncture: infection, bleeding into the pseudomeningocele.

Lumbar drainage: infection, meningitis, bleeding at the insertion site, cerebrospinal fluid leakage, nerve root irritation, headaches.

Reoperation: bleeding, infection, complications related to general anesthesia. Expected duration of participation in the study

12 months

Expected total number of participants enrolled in the study

20 participants

Benefit of the study

The aim of the study is to compare the effect of surgical intervention with conservative management.

Compensation for participation

Participation in this study is not associated with any financial compensation.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Czechia
    • Prague
      • Prague, Prague, Czechia, 16000
        • Recruiting
        • Military University Hospital Prague
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Pseudomeningocele after elective intracranial surgery
  • Willing and able to give informed consent
  • No prior cranial or spinal surgical intervention
  • Pseudomeningocele Palpation Scale (PPS) II-IV, no severe pain of the PMC (VAS 7-10) - Tension MK

Exclusion Criteria:

  • PMC following emergency or trauma surgery
  • Known or suspected infection at the PMC site at recruitment
  • Severe comorbidities preventing participation (e.g. terminal illness, organ failure)
  • Conditions requiring urgent unrelated surgical intervention

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Conservative
Patients managed without surgical procedures, except for skin sutures.
Experimental: Interventional
Patients undergoing local treatment - lumbar drainage insertion, simple wound puncture, fibrin glue or any combination.
Procedure: Lumbar Drainage
Insertion of Lumbar drain
Procedure: Pseudomeningocele Puncture
aspiration of the CSF fluid with injection
Procedure: Puncture with Fibrin Glue Application
after aspiration of the CSF a fibrin glue is injected into the pseudomeningocele
Procedure: Revision
Revision surgery in order to prevent future pseudomeninogocele formation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
CSF Leakage or Tension pseudomeningocoele
Time Frame: 12 months
New-onset wound CSF leakage requiring revision surgery, or pseudomeningocele associated with severe headaches not responsive to analgesics.
12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Infection
Time Frame: 12 months
To compare the infection rate between the two treatment groups.
12 months
Glasgow Outcome Scale Extended (GOSE)
Time Frame: 12 months
To assess functional recovery using the Glasgow Outcome Scale-Extended (GOSE) at 1 year post-surgery.
12 months
Absorption of the Pseudomeningocoele
Time Frame: 12 months
Absorption of pseudomendingocoele at 4 months and 1 year post-surgery assessed by CT or MRI
12 months
Pain
Time Frame: 12 months
Persistence of headache after the surgery - Pain Scale 0-10 (VAS)
12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Charles University, Czech Republic

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2025

Primary Completion (Estimated)

November 1, 2029

Study Completion (Estimated)

November 1, 2030

Study Registration Dates

First Submitted

May 15, 2026

First Submitted That Met QC Criteria

May 22, 2026

First Posted (Actual)

May 29, 2026

Study Record Updates

Last Update Posted (Actual)

May 29, 2026

Last Update Submitted That Met QC Criteria

May 22, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 108/20-55/2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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