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PubMed1992

[A successfully treated case of thoracic meningocele with von Recklinghausen's disease].

Intrathoracic meningocele is an uncommon disease. Only 95 cases in the foreign literature and 13 cases in Japanese literature have been reported since Phol Meningocele occurs most frequently in the sacral and lumbar spinal regions. In this present paper, an 18-year-old female with intrathoracic meningocele associated with neurofibromatosis is described. The patient was admitted to our Surgical Clinic with a complaint of constrictive pain in the upper chest. The meningocele was diagnosed preoperatively and resected surgically by left thoracotomy. The patient has been followed up to for six years without any evidences of local recurrence. However, she recently complains of headache and weakened eyesight because of pituitary tumor, the operative indication of which is now discussed.

Adolescent↗
PubMed1984

CT metrizamide myelography in multiple bilateral intrathoracic meningoceles.

An intrathoracic meningocele is a protrusion of spinal meninges through an intervertebral foramen into the thoracic cavity. The majority occur in association with neurofibromatosis, and bilateral or multiple lesions are rarely seen. In conventional radiography, small meningoceles may be hidden behind other mediastinal structures. To investigate paraspinal masses, computed tomography (CT) with intrathecal contrast material is likely to result in more frequent detection of unsuspected lateral meningoceles. This report details our experience with CT metrizamide myelography in a case of multiple bilateral intrathoracic meningoceles.

Aged↗
PubMed1994

Rudimentary meningocele presenting with a scalp hair tuft. Report of two cases.

BACKGROUND: Rudimentary meningoceles represent a developmental anomaly in which meningothelial elements are found in the skin. The majority of rudimentary meningoceles occur on the scalp over the occiput or along cranial suture lines. They are usually recognized at birth and present as a pink papule or nodule or an area of alopecia. OBSERVATIONS: We present two patients who presented with a scalp hair tuft at birth over a rudimentary meningocele. This finding has not been previously reported. CONCLUSIONS: Rudimentary meningoceles are uncommon developmental anomalies that are of clinical importance due to the occasional presence of connection to the central nervous system. Due to this potential for central nervous system connection, any midline lesion in an infant, including midline hair tufts, deserves careful preoperative evaluation including imaging studies.

Adult↗
PubMed1997

Lateral meningocele syndrome: three new patients and review of the literature.

One female and two male patients with multiple lateral meningoceles are presented. They do not have neurofibromatosis or Marfan syndrome and share findings with the two previously described patients with multiple lateral meningoceles. The original report by Lehman et al. [1977: J Pediatr 90:49-54] was titled "familial osteosclerosis," because osteosclerosis was present in the proposita and her mother; the patient described by Philip et al. [1995: Clin Dysmorphol 4:347-351] also had increased bone density of the skull base and the sutures. Thickened calvaria were present in one of our patients; two had a prominent metopic suture. Other shared findings include multiple lateral meningoceles, Wormian bones, malar hypoplasia, downslanted palpebral fissures, a high narrow palate, and cryptorchidism in males. In addition, our patients showed ligamentous laxity, keloid formation, hypotonia, and developmental delay. A short umbilical cord was noted in two patients. One had a hypoplastic posterior arch of the atlas and an enlarged sella, as reported by Lehman et al. [1977]. Our patients appear to have the same syndrome as previously reported. We suggest it be called "lateral meningocele syndrome," because of this unique finding.

Abnormalities, Multiple↗
PubMed1997

[Value of peroperative endoscopy in treating giant lumbosacral meningocele].

Lombosacral meningocele may be responsible for sciatica, low backache, cauda equina syndrome according to their localization and size. When they are symptomatic, the surgical purpose is to close the communication between the meningeal sac and the cyst. For giant meningocele, acute localization of the communication may be difficult. In such cases, peroperative endoscopy may be useful. We present a case of sciatica related to a giant meningocele extended from L2 to S2. MRI, CT scan and myelography were unable to localize the communication. We used peroperative endoscopy for direct visualization of the communication in order to minimize the surgical approach. An intrathecal nerve root was found strangulated in the communication suggesting an original kind of nerve root suffering. The communication was only closed. The patient made an uneventful recovery with complete relief of symptoms. Magnetic resonance imaging 3 months later showed a significant decrease of the meningocele without any further radicular compression.

Adult↗
PubMed1998

Multiple bilateral thoracic meningoceles without neurofibromatosis: a case report.

Lateral thoracic meningoceles are rare and, in most cases, they are associated with neurofibromatosis. We report a case in which computerized tomography (CT)-myelography established the diagnosis of multiple, bilateral, lateral, thoracic meningoceles without neurofibromatosis. Plain film radiographs are necessary to evaluate any associated kyphoscoliosis and its progression. CT and magnetic resonance imaging demonstrate the extent of bony erosion, and the size and number of lateral thoracic meningoceles. CT-myelography reveals contrast medium in the meningoceles and is the major diagnostic imaging modality.

Humans↗
PubMed1979

Intrathoracic meningoceles and neurofibromatosis.

We describe here four additional cases of intrathoracic meningoceles associated with neurofibromatosis, bringing the total number of reported cases of thoracic meningoceles to 88. Seventy-five (85%) have been associated with neurofibromatosis. Possibly, both dural and regional vertebral dysplasia are intrinsic to neurofibromatosis and contribute to the development of the meningocele.

Adult↗
PubMed1980

Occult anterior sacral meningocele.

Anterior sacral meningocele is a rare congenital malformation consisting of a spinal fluid-filled sac in the pelvis communicating by a small neck with the spinal subarachnoid space through a sacral defect. This entity should be considered if the characteristic scimitar sacrum is observed on a pelvic roentgenogram. If signs and symptoms also suggest a meningocele, special studies such as ultrasonography and myelography are indicated to establish the diagnosis of an anterior sacral meningocele. Computerized tomography provides additional evidence of spinal-abdominal extension of this lesion.

Child↗
PubMed1989

Deletion 3q27----3qter in an infant with mild dysmorphism, parietal meningocele, and neonatal miliaria rubra-like lesions.

Deletion 3q27----3qter in an infant is described. A chromosomal abnormality was suspected because of minor facial dysmorphism and closed parietal meningocele. On the first day of life, a large exudative inflammation appeared on the skin of her back, which completely resolved after 1 week. Biopsy showed dilated sweat gland openings resembling miliaria rubra, which has not been previously reported in this age group. It is unclear if the skin change was due to the chromosomal abnormality. The meningocele was repaired at age 8 months. At age 20 months, slight neurodevelopmental delay was evident, the main features being hypertonicity and inability to walk without support. The patient has two healthy sisters, and prometaphase chromosome studies in both parents were normal. This infant represents the first example of del3q27----3qter and the first reported association of meningocele with an abnormality of chromosome 3.

Abnormalities, Multiple↗
PubMed1989

Case report 582: Lumbosacral meningocele and aortic aneurysm in Marfan syndrome.

A patient with Marfan syndrome presented with enlargement of lumbosacral spinal canal with a bulky meningocele, and a fusiform aneurysm of the ascending aorta. In Marfan syndrome, the presence of a meningocele is extremely rare, but 60% of the patients develop cardio-vascular complications (a frequent cause of death). MRI is the imaging technique of choice for the diagnosis of meningocele and aortic aneurysm.

Adult↗
PubMed1981

Anterior sacral meningocele discovered by whole body computerized tomography: case report.

A case of anterior sacral meningocele which was clearly visualized on whole body computerized tomography is presented. Posterior surgical approach with ligation of the narrow communication between the sacral dural sac and the meningocele alleviated the subjective complaints of a feeling of abdominal distention and of dysuria. For the purpose of postoperative follow-up study, examination by whole body computerized tomography proved to be the best method of evaluating the size of the meningocele and also the state of neighbouring structures.

Adolescent↗
PubMed1991

Management problems in cases with a combination of asymptomatic occult intrasacral meningocele and disc prolapse.

Report of two cases who suffered from lumbo-ischialgia and had as well a disc prolapse as an intrasacral meningocele. The actual clinical symptoms seemed to be caused by the disc prolapse and not by the meningocele, which was considered to be asymptomatic. Therefore only operative treatment of the protruded disc was undertaken. The post-operative course confirmed that this decision was correct. Questions of classification and clinical symptoms of intrasacral meningoceles are shortly discusses.

Adult↗
PubMed2005

Epithelioid hemangioendothelioma and multiple thoraco-lumbar lateral meningoceles: two rare pathological entities in a patient with NF-1.

Epithelioid hemangioendothelioma (EHE) is a rare vascular soft-tissue tumour of intermediate malignancy. Neurofibromatosis type I (NF-1) is a genetic syndrome associated with soft tissue sarcoma and higher risk of developing neoplasia. Lateral meningoceles are uncommon entities, being mostly associated with NF-1. We report a case of a 31-year-old woman, with NF-1 and past history of right thalamic/peduncular astrocytoma WHO grade II, admitted to the Neurosurgery Department in December 2003 due to severe low back pain, irradiating to the left leg without a radicular pattern. Thoraco-lumbar magnetic resonance imaging (MRI) showed a large left posterior paravertebral expansive lesion, bilateral and multiple thoraco-lumbar lateral meningoceles and dural ectasias with scalloping of the vertebral bodies. Biopsy of the paravertebral mass lesion disclosed EHE. We present this case because of the novel association between NF-1 and EHE, and the unusual aggressiveness of the neoplasia. Additionally, we highlight the co-existence of bilateral and multiple lateral meningoceles.

Adult↗
PubMed2004

Anterior sacral meningocele with presacral cysts: report of a case.

Anterior sacral meningocele is a rare anomaly most frequently presenting as a presacral mass. Since the first description in 1837, approximately 150 cases have been reported. The case presented is a 37-year-old female in whom an asymptomatic presacral mass was discovered during her first delivery. Because normal delivery was impossible, a cesarean section was performed. A year later, in a regional hospital a "cystic presacral tumor" was treated with biopsy and drainage. Four years later, she developed constipation caused by perineal compression for which she was admitted to our department in which two anterior presacral cysts were excised. The recovery was complicated with meningitis, which was successfully treated with antibiotics. Whenever a presacral mass is found, anterior sacral meningocele has to be a diagnostic consideration. The symptoms are usually related to the compression on rectum, bladder, and sacral nervous plexus. Rectal examination and radiography of the pelvis with the sacral bone showing the "scimitar sign" are the main diagnostic methods. Myelography, computed tomography, and magnetic resonance imaging are the best methods for identifying the precise anatomy of sacral meningocele and for proper planning of the operation. Transvaginal or transrectal aspiration and drainage are not advised, because they may result in a lethal outcome caused by sepsis.

Anti-Bacterial Agents↗
PubMed1982

Dandy-Walker cyst associated with occipital meningocele.

Two cases of Dandy-Walker cyst associated with occipital meningocele are presented. Only 9 cases with such association have been described in the literature. In our patients computed tomography clearly demonstrated direct communication of a posterior fossa cyst with an occipital meningocele at one end and with the fourth ventricle at the other. Occipital meningocele might simply be an expression of increased intracystic pressure in Dandy-Walker cyst in embryonic life, or such association might suggest its morphogenetic situation during embryogenesis.

Brain↗
PubMedDate not supplied

Pelvic meningocele can be missed during laparoscopy.

Pelvic meningocele is an uncommon condition and is frequently asymptomatic. The diagnosis easily can be mistaken as ovarian cyst on pelvic sonography. In many reported cases, the diagnosis was made during laparotomy for presumed ovarian cysts. Myelography, computerized tomography (CT), or magnetic resonance imaging (MRI) is useful for definitive diagnosis. A 49-year-old woman, who had a normal diagnostic laparoscopy 3 years prior, was referred for a persistent ovarian cyst. Repeat laparoscopy revealed a retroperitoneal cyst in the left pelvic sidewall. Both ovaries and fallopian tubes were normal. Subsequent CT and MRI were used to diagnose pelvic meningocele. We speculate that pelvic meningoceles can be missed during laparoscopy due to the increased intraperitoneal pressure and the potential reduction in the cerebrospinal fluid pressure at the lumbosacral level.

Diagnostic Errors↗
PubMed2003

A neurofibromatosis type 1 patient with severe kyphoscoliosis and intrathoracic meningocele.

The patient presented with neurofibromatosis and a dystrophic kyphoscoliosis around the cervico-thoracic junction. When the patient was 59 years old, he started to suffer from dyspnea caused by an intrathoracic meningocele in the upper left thoracic cavity. A wide laminectomy from T2 to T5 was performed and the meningocele was resected. Although the dyspnoea disappeared postoperatively, the patient started to neurologically deteriorate. Laminectomy alone caused instability around the apex of the kyphosoliosis and spinal cord compression. Halo cast was applied and brought remarkable recovery of neurologic deficits. This result encouraged us to perform posterior fusion in situ from C3 to L2 with bone graft from the iliac crests and the Luque technique in conjunction with the Isola system. This resulted in the patient being able to walk again. The removal of the posterior element predisposes the patient to unstable postlaminectomy kyphosis and removes valuable bone stock required for posterior spinal fusion. For this reason, spinal fusion should have been conducted during surgery for the patient's meningocele.

Bone Transplantation↗
PubMed1977

Occult thoracic and sacral meningoceles.

Two cases of occult meningoceles are reported. The first case exhibited a combination of thoracic meningocele and neurofibromatosis with additional generalised osteomalacia. The second case was an anterior sacral meningocele. Based on these reports pathogenesis, diagnosis and therapy are discussed. The importance of myelography for the diagnosis of this condition and the indications for operative treatment are pointed out.

Adult↗