Meningocele Presenting Research Articles

Surgical management of a rare giant sacral meningocele in a child

IntroductionAnterior sacral meningocele is a rare congenital disorder, occurring isolated or in syndromic disease. Case reportA 15-year-old patient who complained of abdominal pain and urinary dysfunction was managed surgically. Imaging diagnosed a giant presacral meningocele and agenesis of the coccyx. DiscussionThe presentation of sacral meningocele can be poorly symptomatic, which is why some patients are diagnosed late. Sometimes, diagnosis is suggested by non-specific abdominal symptoms or complications. Abdominal-pelvic radiological examination and lumbar spine MRI are essential, and treatment must be surgical. There are several surgical approaches, but currently no consensus. ConclusionAn unusual huge presacral cystic mass in a young patient may be isolated or part of a syndrome, and can be asymptomatic for a long time, leading to late diagnosis. The surgical approach should be based on multidisciplinary discussion. We operated on a giant anterior sacral meningocele in a child using a posterior approach, with a satisfactory result.

Facial Nerve Meningocele Presenting as Sudden Sensorineural Hearing Loss.

Facial Nerve Meningocele Presenting as Sudden Sensorineural Hearing Loss.

Unilateral vagus nerve lesion revealing clival meningocele

IntroductionCranial nerve lesions can be secondary to a space-occupying lesion of the skull base compressing adjacent nerves. Case reportWe report the case of an 84-year-old man, who presented with rapid and concomitant onset of dysphagia and ipsilateral recurrent laryngeal nerve paralysis, suggesting an isolated lesion of the vagus nerve. MRI revealed a diagnosis of previously unknown clival meningocele. DiscussionUnilateral vagus nerve paralysis constitutes an exceptional mode of presentation of meningocele. Only a few isolated cases of clival meningocele have been reported to date, with no cranial nerve repercussions. The symptomatic management adopted in this case allowed rapid improvement of the patient's disorders.

Anterior sacral meningocele presenting as right adnexal cyst

A 47-year-old woman presented with chronic pelvic pain for 6 months. There was no history of trauma or surgical operation. Pelvic ultrasound was performed and revealed an anechoic cyst in the right pelvic areas. The origin of the cyst could not be determined on ultrasound examination. Magnetic resonance imaging showed a thin-walled cystic lesion in the right adnexa. The lesion was not associated with the ovaries. Posteriorly, it was communicating with the spinal subarachnoid space (Figure, Top left, Top right, Bottom). Based on imaging findings, the patient was diagnosed with anterior sacral meningocele.

Temporal Bone Meningocele Presenting as a Pulsatile Mass of the External Auditory Canal

Meningocele is a protrusion of meninges through a defect in the skull base. It is a rare but potentially life-threatening condition requiring surgery. We present a case of 59-year-old woman complaining of persistent otorrhea of the right ear and a pulsating cystic mass occupying the external auditory canal in her right ear. The patient had undergone right canal wall up mastoidectomy and tympanoplasty about 30 years ago. Radiological evaluations revealed a bony defect at the tegmen tympani and tegmen mastoideum, with a cystic mass filling this defect and the external auditory canal, suggesting temporal bone meningocele. The meningocele was resected and the bony defect of tegmen was successfully repaired via combined transmastoid and middle cranial fossa mini-craniotomy approach.

Lateral Meningomyelocele in a Neonate: A Case Report

Lateral presentation of meningocele and meningomyelocele is extremely rare. Most of the lateral meningocele described are associated with other syndromes. Isolated lateral meningomyelocele cases are rarer still. We herein report a neonate with isolated lateral gluteal meningomyelocele.

A tail of sacral agenesis: delayed presentation of meningocele in sacral agenesis

Sacral agenesis is a congenital condition associated with multiple orthopedic, spinal, abdominal and thoracic organ deformities. Meningocele is commonly found among patients with sacral agenesis. We present the first case in the literature describing a delayed presentation of terminal (posterior) meningocele in an adult patient born with sacral agenesis. Surgical repair was performed and is the best treatment option for significantly large lesions, with postoperative CSF leak being the main complication.

Maternal anterior sacral meningocele presenting as acute urinary retention in pregnancy

Maternal anterior sacral meningocele presenting as acute urinary retention in pregnancy

Anterior sacral meningocele presenting as constipation

Anterior sacral meningocele (ASM) is a rare form of spinal dysraphism in children. Usually asymptomatic, it can present as constipation, urinary problems or rarely neurological symptoms. High index of suspicion with careful clinical examination is necessary to make early diagnosis. Magnetic resonance imaging is the investigation of choice. We describe a successfully managed young child with ASM associated with rib and vertebral defects.

Lateral sacral meningocele presenting as a gluteal mass: a case report

IntroductionLateral meningocele is a very rare disorder. It has been reported in patients with neurofibromatosis or Marfan's syndrome. Previous reports have described lateral meningoceles in the thoracic or cervical region. Lateral meningocele in the sacral area was reported in the literature only once.Case presentationWe describe a 3.5-year-old Iranian girl who presented with a lateral gluteal mass. Neuroimaging and intra-operative evaluation showed that the mass was a lateral sacral meningocele with spinal communication through the iliac bone. We also present a review of the literature about this entity.ConclusionsAlthough lateral meningoceles especially in the sacral region are rare disorders, their possibility should always be considered in young patients presenting with a paravertebral or gluteal mass.

Patient with congenital optic nerve meningocele presenting with left orbital cyst

Meningocele of the optic nerve is a rare condition defined as dilatation of the optic nerve by spinal fluid not due to other pathology, classically presenting with headaches or progressive visual decline and usually follows a rapidly progressive course. Surgical decompression is the standard treatment with improvement or arrest of progression in most cases. We describe a case of a child with multiple congenital anomalies including a left optic nerve meningocele that progressively expanded and caused displacement of the orbit laterally resulting in severe cosmetic deformity and complete blindness in the left eye. We describe our surgical decompression as well as review the literature on optic nerve meningocele.

Giant Anterior Sacral Meningocele Presenting as Bacterial Meningitis in a Previously Healthy Adult

Meningocele may be asymptomatic and incidentally discovered. Presenting as a retrorectal mass, sacral meningocele may produce urinary, rectal, and menstrual pain. Anterior sacral meningocele may be the cause of tethered cord syndrome. This article presents a case of a previously healthy 39-year-old man with large meningeal herniation that occupied the entire pelvis who developed symptoms of bacterial meningitis. A 39-year-old man was admitted with fever, chills, headache and photophobia. Escherichia coli was isolated from cerebrospinal fluid culture. Moderate improvement regarding meningeal symptoms was noted due to intravenous antibiotic therapy, but intense pain in the lower back associated with constipation, fecal and urinary incontinence, and saddle anesthesia developed. Abdominal ultrasound was negative. Plain radiographs and computed tomography demonstrated sacral bone defect and retrorectal expansive mass. MRI confirmed anterior sacral meningocele with cord tethering. After posterior laminectomy and dural opening, communication between meningocele and intrathecal compartment was obliterated. Computed tomography-guided percutaneous drainage through the ischiorectal fossa was performed to treat residual presacral cyst. Delayed diagnosis in our patient was related to misleading signs of bacterial meningitis without symptoms of intrapelvic expansion until the second week of illness. In our patient, surgical treatment was unavoidable due to resistive meningitis, acute back pain, and symptoms of space-occupying pelvic lesion. Neurosurgical approach was successful in treatment of meningitis and neurological disorders. Computed tomography-guided evacuation of the residual retrorectal cyst was less invasive than laparotomy, resulting in normalization of defecation and miction despite incomplete evacuation. Further follow-up studies may provide insight into the most effective treatment of such conditions.

Meningocistocele orbitario

Encephalocele is defined as a protrusion of cranial contents beyond the normal confines of the skull. Encephaloceles occur with an incidence of approximately 1 in 3,000-10,000 births and are categorized based on location in the skull. Orbital meningoencephalocele is a rare congenital abnormality caused by a defect of the cranio-orbital bones that usually manifests soon after birth as a soft mass associated with exophthalmos. We present a case of a giant orbital meningocele presenting as an orbital mass in a 15 months-old girl. Preoperative diagnosis was confirmed by CT-scan and magnetic resonance imaging.

Lateral thoracic meningocele presenting as a retromediastinal mass

Lateral thoracic meningocele presenting as a retromediastinal mass

Lateral thoracic meningocele presenting as a retromediastinal mass

Lateral thoracic meningocele presenting as a retromediastinal mass

Rudimentary Meningocele Presenting With a Scalp Hair Tuft

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. We present two patients who presented with a scalp hair tuft at birth over a rudimentary meningocele. This finding has not been previously reported. 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.

Anterior sacral meningocele presenting as a pelvic/abdominal mass in a patient with Marfan syndrome

Anterior sacral meningocele presenting as a pelvic/abdominal mass in a patient with Marfan syndrome

Anterolateral lumbar meningocele presenting as an ovarian cyst, in a patient with neurofibromatosis

A case of an anterolateral lumbar meningocele in a patient with neurofibromatosis is presented. As anterolateral lumbar meningocele may present itself only by non-specific symptoms like low back pain or abdominal pain, such symptoms require prompt diagnostic work up in patients with neurofibromatosis. The significance of MR imaging in early recognition of this rare anomaly is emphasized.

Unsuspected meningocele presenting as neurogenic bladder dysfunction in an adult

AbstractTwo adult patients with neurogenic bladder dysfunction secondary to unsuspected meningoceles are described. The implications of such problems and the need for complete neurourologic evaluation are important.

Anterior sacral meningocele presenting as abdominal mass

Anterior sacral meningocele is a rare entity. It arises from a congenital defect of the sacrum and the coccyx through which herniation of the caudal portion of the meninges and their contents occurs, forming a cyst-like structure. The cystic mass, which lies between the rectum and sacrum, produces a variety of symptoms depending on its size and contents and constitutes a diagnostic problem. A case of anterior sacral meningocele is presented, including the physical signs, differential diagnosis, and the dangers of aspiration or surgical intervention.