Cervical meningocele and associated spinal anomalies (original) (raw)
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Cervical Myelomeningocele and Hydrocephalus Without Neurological Deficit: A Case Report
American-Eurasian Journal of …, 2007
Cervical myelomeningocoele is a rare dysraphic lesion which rarely presents with neurological deficit in affected infants. We report a 9-day-old female neonate with a posterior midline neck swelling and a large head noted at birth; that had a mid cervical myelomeningocoele and hydrocephalus without neurological deficit. All the brain ventricles were dilated on ultrasound and the fluid filled neck swelling showed no evidence of Chiari malformation or cord tethering. These associations were also absent during spinal exploration, repair of myelomeningocoele and ventriculo-peritoneal shunting. Except for a shunt revision necessitated by shunt blockade occurring 12 days after surgery, there has been no neurological deterioration since eighteen months of initial surgery. We conclude that an infant with cervical myelomeningocoele and hydrocephalus does not always have a Chiari malformation and could present without neurological deficit. A prolonged follow-up is however paramount in the event that the child may subsequently develop neurological deterioration.
True cervicothoracic meningocele: a rare and benign condition
Cervical meningoceles are rare spinal dys-raphism, accounting for approximately 7% of all cystic spinal dysraphism. In spite of the rarity , the clinical course is most of the times benign. The surgical treatment includes resec-tion of the lesion and untethering, when presented. We present a 14-day-old female child with true meningoceles who underwent to surgical excision and dura-mater repair. Retrospect analysis of the literature concerning true cervical meningocele is performed. By reporting this illustrative case, we focus on its classification and its differentiation from other types of cervical spinal dysraphism, such as myelocystocele and myelomeningocele. Although its course is benign, it is mandatory a continuum follow up with periodic magnetic resonance imaging of spinal cord, since late neurological deterioration has been described.
Cervical meningocele with tethered cord in a seven-years old child: Case Report
The Internet Journal of Pediatrics and Neonatology, 2009
Meningoceles are typically associated with other congenital spinal anomalies, and are usuallydiagnosed in childhood. Cervical meningoceles are extremely uncommon congenital spinal anomalies. Most patients have no neurological deficit at presentation and treatment has been mainly cosmetic. Treatment aims to prevent future neurological deterioration, and should include careful intradural exploration with untethering of the cord. We report a case of cervical meningocele in a 7-year-old girl. The tethering band, confirmed intra-operatively. Untethering of the cord was performed together with resection of the sac and repair of the dura. Early intervention is recommended even in cases with normal neurological examinations in order to prevent deterioration. These cases should be operated as soon as possible after birth.
Cervical meningocele with tethered cervical cord in a Chinese infant
Cervical meningocele and myelomeningocele are rare spinal dysraphic lesions. Unlike lumbosacral dysraphic lesions, there is often no neurological deficit in infants with cervical lesions, thus the subtle features of cervical cord tethering may be overlooked on imaging. We report a case of cervical meningocele in an 8-month-old girl. The tethering band, confirmed intra-operatively, was not evident on imaging. Untethering of the cord was performed together with resection of the sac and repair of the dura. Tethered cord should be suspected in the presence of cervical meningocele and intact neurology. It should be carefully looked for using high-resolution magnetic resonance imaging or computed tomography. Treatment aims to prevent future neurological deterioration, and should include careful intradural exploration with untethering of the cord.
Journal of Institute of Medicine, 2007
Nepal, by her mother, presenting with two soft cystic swellings on the back since birth. The lesions were progressively getting enlarged. The mother also noticed that her child did not move her left leg and there was only minimal movement on her right leg. The infant would not cry on passing urine or stool and was always dribbling urine. On probing the family and gestation history. It was found that the mother was a 23 year-old housewife from a village in Shindhupalchowk. The infant was delivered at home at 40 weeks gestation with complications. She had not sought any ante/postnatal checkups. There was no past history of any serous medical illnesses and no history of drug abuse or use of medicines and infections during pregnancy. She did not take any vitamins or iron supplements during her gestation. This was her second child of non-consanguineous parents; and the first child had no known congenital anomalies. Physical Examination (Fig 1) Physical examination revealed two soft cystic swellings on the back, smaller one at the lower thoracic level and the larger one on the lumbosacral region. The rostral lesion on the lower
Pediatric Neurosurgery
Background: Lateral meningocele syndrome (LMS) is an exceedingly rare connective tissue disease with phenotypic anomalies similar to those seen in Marfan syndrome, Ehler-Danlos syndrome, and Loeys-Dietz syndrome. However, this syndrome is invariably associated with the presence of multiple lateral thoracolumbar spinal meningoceles: a distinct point of phenotypic divergence from other connective tissue disorders. The etiopathogenesis of this syndrome has recently been linked to truncating mutations within exon 33 of NOTCH3. Despite numerous reports, neurosurgical management of multiple spinal meningoceles remains poorly defined in the literature. We conducted a literature review to provide insight into the nosology, clinical significance, and neurosurgical management strategies of this distinct connective tissue disorder. Summary: Our literature search revealed 11 articles (16 cases) of LMS, which included 9 males
Isolated giant intrathoracic meningocele associated with vertebral corpus deformity
Interactive cardiovascular and thoracic surgery, 2004
Published reports of intrathoracic meningocele with vertebral corpus defects in the absence of neurofibromatosis are very rare. We report a 9-year-old male with intrathoracic meningocele. We believe that vertebral corpus defects may play a certain role in the etiology of intrathoracic meningocele.
Surgical Neurology, 2003
In very rare dysraphic cases, it is not clear whether the primary abnormalities are in the neural elements, or in the bony elements. We describe a case of segmental hypoplasia of the spinal cord, with absent nerve roots in the afflicted segments, and associated meningocele and vertebral abnormalities. We illustrate the arguments for and against the classification of this lesion either as an atypical case of myelomeningocele (MMC) or as a mild case of segmental spinal dysgenesis (SSD). Possibly, in this exceptional case, the primary defect is in the neural tissue like in more usual cases of MMC and not in the spine, like in segmental spinal dysgenesis.