Cervical lipomyelomeningocele: case Illustration (original) (raw)
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Tethered Cord Syndrome Associated With Lumbar Lipomyelomeningocele: A Case Report
Cureus, 2022
The objective is to describe a rare case of lumbar lipomyelomeningocele presenting as progressive urinary incontinence. Lipomyelomeningocele is a type of closed spinal dysraphism typically presenting as a lipomatous mass contiguous with a neural defect above the gluteal crease. Tethered cord syndrome is defined as symptoms and signs caused by excessive spinal cord tension from an abnormally low conus medullaris, with an abnormally thick filum terminale attached to the lower sacral region. A 19-year-old male with no remarkable medical history presented with low back pain and urinary incontinence for the past one year. On physical exam patient had normal motor strength, sensory testing to all modalities was intact. The rectal tone was normal, and no saddle anesthesia was noted. MRI lumbar spine revealed lumbar lipomyelomeningocele with associated tethered cord syndrome. The patient underwent tethered cord release surgery with lipoma excision. Pathology of the soft tissue showed fibrovascular tissue and mature adipose tissue consistent with lipoma. The majority of cases of tethered cord syndrome are related to spinal dysraphism, a rare pediatric syndrome. It is potentially treatable if caught early, and MRI can help with an accurate diagnosis of the condition. Older adults are more likely to present with urological and neurological complaints. Surgical un-tethering is indicated in patients with progressive symptoms. In our case, the only presenting symptom was urinary incontinence, and the neurological exam was normal other than lower lumbar paraspinal tenderness.
Lipomyelomeningocele Lumbosacral: A Case Report
Lipomyelomeningocele (LMMC) is a type of congenital occult spinal dysraphism consisting of the presence of lipomatous tissue attached to the dorsal spinal cord, which protrudes though a spinal defect along with the menings or spinal cord to form a posterior mass under the skin. LMMC is the commonest cause of congenital tethering (tethered cord syndrome) and causes neurological deterioration due to the conus medullaris and root ischemia. Here we presented a 6 year old girl with a lump over the back region since birth. The lump was progressively increasing in size. There was history of urinary and fecal incontinence since birth. Local examination of the lumbosacral region revealed a single lump with no redness over it, spherical in shape, 12×10 cm in size, soft consistency, and fixed. CT Scan of lumbosacral spine was done which revealed soft tissue mass at lumbosacral that connected with defect canal sacral from L5 until S2. We diagnosed patient with lipomyelomeningocele. Surgery was performed and there are no post operative complications and now after 1 month of surgery the symptoms were improved. Lipomyelomeningocele is rare case in our Department. Surgical treatment is indicated because the patient had urinary disturbance. There are no post operative complications and now after 1 month of surgery the symptoms were improved.
Lipomyelomeningocele: pathology, treatment, and outcomes
Neurosurgical Focus, 2012
L ipomyeLomeningoceLe lies within the spectrum of closed neural tube defects. It represents a complex disorder that may present with neurological deficits secondary to the inherent tethered cord. Treatment strategies vary with subtype, neurological function, and goals of surgery. We present a review of lipomyelomeningocele including embryology, evaluation, treatments, and outcomes.
Scholars Journal of Medical Case Reports, 2021
Lumbosacral lipomasrepresent the most common forms of occult spinal dysraphism. Lipomyelomeningocele is a rare birth defect of the spine. It's a lipoma that is tightly attached to the dorsal surface of a neural placode and extend dorsally through spina bifida to be continuous with subcutaneous fat. MRI plays an essential role in the diagnosis and treatment. We report the case of an 18-month-old infant in whom we detected a lipomyelomeningocele during the exploration of scoliosis.
Lipomeningocele with Tethered Cord Syndrome in an Adult: A Case Report
Journal of Nepal Medical Association
Lipomeningocele is a closed neural tube defect characterized by the presence of spinal tissue within the spinal cord, with a junction between the spinal cord and a lipoma. It has a prevalence of 0.6 per 10,000 live births. A 29-year-old female presented to the outpatient clinic with complaints of weakness in both legs (more on the right) and tingling sensation and pain over her right thigh and legs for 1 year. She also mentioned swelling in her lower back since birth, which has been growing progressively since childhood. Magnetic resonance imaging of the spine revealed a low-lying spinal cord with the conus lying at the lower end of the L2 vertebral body. Spinal decompression with detethering of the cord and excision of the lipomeningocele was undertaken via a posterior midline incision. Prompt surgical intervention are crucial for symptom relief and prevention of neurological deterioration.
The spectrum of musculoskeletal problems in lipomyelomeningocele
Journal of Children's Orthopaedics, 2013
Purpose Patients with lipomyelomeningocele (LMMC) represent a unique population within the spectrum of spinal dysraphism. The natural history of LMMC remains poorly defined. The description and prevalence of the presenting orthopaedic clinical signs and symptoms for LMMC have been infrequent and often documented only in general terms. The goal of this study is to define the patterns and prevalence of presenting clinical musculoskeletal signs and symptoms in LMMC patients. Methods This study was a retrospective review of charts of all patients identified as having LMMC in our spina bifida clinic. Patient charts with incomplete data or diagnoses other than LMMC were excluded from the analysis. Data collected included age at initial tethered cord release (TCR); repeat TCR; limb length discrepancy; foot deformities; asymmetry of motor and sensory deficits; presence of scoliosis; orthotic needs; assistive devices; functional status. Results We identified 32 patients with LMMC (21 female ...
Cervical meningocele and associated spinal anomalies
Child's Nervous System, 1987
Simple meningoceles are infrequent forms of dysraphism and are often benign. They have been associated with other spinal anomalies. The uncommon cervical meningocele may have a higher propensity to be associated with other spinal anomalies. Four patients with cervical meningocele are presented with radiographic evaluation and clinical course. Multiple abnormalities were documented radiographically and operatively, including hydrocephalus, Chiari malformation, hydromyelia, lipomeningomyelocele, tethered cord, thickened filum terminale, diastematomyelia, Klippel-Feil syndrome, and thoracic hemivertebrae. Prior to the development of any late neurological abnormality from associated spinal anomalies, magnetic resonance imaging is recommended early in a child born with a simple meningocele.
A Lipomyelomeningocele with Tethered Cord Syndrome Associated with Scoliosis and Clubfoot
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2012
Background: A lipoma in limbosanal region can be associated with myelomeningocele with tethered cord. Tethered cord means abnormally low conus medullaris with abnormally thick filum terminale attached to lower sacral region. Objective: The case was discussed because there is rare association between lipomy elomeningocele with tethering of cord, scolosis and clubfoot. The operation was done by 'S' shaped transverse incision crossing over the middle of the lump. Excision of lipoma was done. Neural placode was identified and dethering of cord and repair of sac was done. Results: The muscle power after surgery was improved. There was no bladder disturbance and gait was intact. Conclusion: There was rare association of many congenital anomalies. Early diagnosis and surgery prevent future cord infarction and scoliosis, due to undue traction of cord.
Prenatal diagnosis of lipomyelomeningocele by ultrasound and magnetic resonance imaging (MRI)
Clinical and Experimental Obstetrics & Gynecology, 2015
Objective: The authors report a case of a lipomyelomeningocele with tethered cord, revealed on prenatal ultrasonography and confirmed by fetal magnetic resonance imaging (MRI). Materials and Methods: A 32-year-old woman, gravida 1 para 1 underwent the routine second trimester prenatal ultrasound scan at 22 +5 weeks of gestation at the present hospital. Results: The scan indicated an echoic semisolid subcutaneous mass covered by skin, posterior to the lumbosacral spinal canal of the fetus. Based on the findings indicating occult dysraphism, a fetal MRI examination was conducted, revealing that the mass was extending to the spinal cord, tethering the cauda equina. The diagnosis of lipomyelomeningocele was established. Conclusion: Lipomyelomeningocele is a form of closed neural tube defect with unclear predisposing factors. Its prevalence ranges between 0.3 and 0.6 per 10,000 live births. It leads to progressive conus tethering with associated neurological, urinary, and gastrointestinal deficits, demonstrating the importance of prenatal diagnosis.
Lipomyelomeningocele: Epidemiological Studies in a Pediatric Neurosurgery Department of Bangladesh
Bangladesh Journal of Neurosurgery
Background: Spinal dysraphism, one of the most common birth defects, has been estimated to occur annually in more than 320,000 infants worldwide. Lipomyelomeningocele (LipoMMC) is a closed neural tube defect in which the surface lipomatous tissue is attached to the spinal cord. LipoMMC results from premature disjunction of the epithelial ectoderm from the neural ectoderm at a gestational age of 18–28 postovulatory days.Both genetic and environmental factors are suggested to have important roles in the occurrence of neural tube defects. In addition, variables such as vitamin B 12 deficiency, maternal hyperinsulinemia,maternal dietary glycemic intake, maternal obesity and use of antiepileptic medications during pregnancy have been suggested as risk factors for spinal dysraphism. Objective:The aims and objectives of this study was to see the epidemiology of Lipomyelomeningocelein our population. We shall also compare our result with other previous study result. Materials and method: It...