We report a 27-year-old female who presented with abdominal distension, saddle anesthesia, and lower back pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying...We report a 27-year-old female who presented with abdominal distension, saddle anesthesia, and lower back pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Anterior approach was chosen, uterine didelphys was identified and mobilized, meningocele identified and gentle drainage with subsequent resection of the cyst wall and watertight closure was achieved. Subsequent MRI demonstrated resolution of most the sacral meningocele. Patient symptoms improved and are doing well.展开更多
Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can o...Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can occur with growth. Surgical treatment, in addition to avoiding rupture and correcting the aesthetic damage, will preserve neurological functions. We report 2 cases that we took care of. They are a 5-month-old infant and a 3-year-old girl. The first presented a 7 cm rounded meningocele pedunculated through the C1 lamina defect. The second presented an 8.6 cm polylobed meningocele pedunculated through the C2 lamina defect. They both underwent surgery with good progress.展开更多
Asymptomatic intrapelvic meningocele is rare. Here, we report the case of a 30-year-old Chinese man who underwent sigmoidectomy due to megacolon. During the operation, an intrapelvic cyst was found and resected. Menin...Asymptomatic intrapelvic meningocele is rare. Here, we report the case of a 30-year-old Chinese man who underwent sigmoidectomy due to megacolon. During the operation, an intrapelvic cyst was found and resected. Meningocele was confirmed by histological examination. The patient recovered well postoperatively with the ex- ception of liquorrhoea. Conservative therapy was initiated, including draining, anti-infection and specific posture maintenance. During the following week, liquorrhoea was generally relieved and the patient was discharged. This is the first known report of liquorrhoea associated with intrapelvic meningocele resection successfully treated by conservative therapy. Our case indicates that conservative treatment may be considered for similar cases so that a second surgery is avoided.展开更多
Objective: The authors report a rare case of giant thoracic meningocele causing acute respiratory compromise, treated with a ventriculoperitoneal shunt. Case Report: We report the case of a 36-year-old with severe sco...Objective: The authors report a rare case of giant thoracic meningocele causing acute respiratory compromise, treated with a ventriculoperitoneal shunt. Case Report: We report the case of a 36-year-old with severe scoliosis status post repair over a decade ago, neurofibromatosis type I, and a known large meningocele in the left thoracic cavity, presenting with new acute respiratory compromise. She was taken to the operating room for a lumboperitoneal shunt, but the operation was aborted due to her severe spinal deformity. Two days later, she successfully underwent a procedure for ventriculoperitoneal shunt placement. Upon discharge a week later, the patient was hemodynamically stable, able to move all extremities with good strength, and demonstrated improved oxygenation. In the following 7 months, the patient demonstrated continued minimal requirement on nasal cannula, and MRI showed a stable left thoracic giant meningocele. Conclusion: Ventriculoperitoneal shunting is a method of treating and stabilizing acutely symptomatic giant meningoceles.展开更多
Anterior sacral meningocele is characterized by the herniation of the thecal sac into the retroperitoneal space. A 33-year-old man was referred to our hospital with the complaints of a longlasting constipation and non...Anterior sacral meningocele is characterized by the herniation of the thecal sac into the retroperitoneal space. A 33-year-old man was referred to our hospital with the complaints of a longlasting constipation and nonspecific lower abdominal pain. At ultrasound, a cystic mass was detected at the presacral space. Computed Tomography revealed a defect at the anterior aspect of the sacrum, together with a presacral cystic mass which showed a connection with the dural sac. At Magnetic Resonance Imaging, it was demonstrated that the cystic mass made an impression on the rectum, and did not possess any solid components. An anteroposterior pelvis radiogram demonstrated a sacral deformity and the scimitar sign. Upon these imaging findings, the patient got the diagnosis of an anterior sacral meningocele. The possibility of an anterior sacral meningocele must always be kept in mind in the differential diagnosis of a pelvic cystic mass.展开更多
We report a 24-year-old male who presented with abdominal distension, constipation and left sided groin pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying m...We report a 24-year-old male who presented with abdominal distension, constipation and left sided groin pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Initially a posterior approach with lumbosacral laminectomy (L5 - S4) was performed. The ostium of the meningocele was identified with several nerve roots identified passing through, adjacent and into the defect. As nerve roots traversed the ostium, watertight closure was not feasible without sacrificing nerve roots. Subsequent MRI demonstrated recurrence of approximately 60% of the anterior sacral meningocele. We therefore opted to approach the ASM anteriorly via an anterior approach with the help of colorectal surgical colleague. The ASM was completely embedded within the sigmoid and upper to mid rectal mesentry, with its own vascular supply to the thick walled capsule. This case highlights the need for a combined approach due to the incorporation of the pseudomeningocele into the omentum with the development of its own blood supply.展开更多
Spinal dermoid cysts are gradually progressive benign tumors that may be congenital or acquired. They account for 0.8% to 1.1% of all primary spinal tumors. MRI is the gold standard for the radiological assessment. Ma...Spinal dermoid cysts are gradually progressive benign tumors that may be congenital or acquired. They account for 0.8% to 1.1% of all primary spinal tumors. MRI is the gold standard for the radiological assessment. Management is difficult for tumors involving highly eloquent areas such as the conus medullaris. In this report, we present a rare case of an adult woman with dermoid cysts in the conus medullaris associated with a sacral meningocele which was treated with a midline myelotomy that drained yellowish keratinous fluid and decompressed the cyst. No aggressive attempt at complete resection of the cyst wall was undertaken. The patient fully recovered, and her condition considerably improved after surgery and remains good at a 6-month follow-up.展开更多
Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare.We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait...Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare.We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait ataxia.Magnetic resonance imaging revealed that a dorsal intradural extramedullary cystic lesion extended from T1 to T5 and compressed the spinal cord.A left lateral intrathoracic meningocele pouch was found incidentally at the level of T1.The arachnoid cyst as well as meningocele was removed and the spinal cord compression was relieved.Arachnoid cyst was confirmed by histological examination.The patient recovered well postoperatively.This is the second report of such a case in the world according to the available literature.The take-home message for our case is that the surgical approach should be individualized,depending on the size and location.展开更多
A female infant, named Anum 1.8 kg was born on 9th August 2007 at Jinnah Postgraduate Medical Centre (JPMC) with a big head, Occipitofrontal Circumference (OFC) 36 cm. She was admitted on 29th August 2007 and was disc...A female infant, named Anum 1.8 kg was born on 9th August 2007 at Jinnah Postgraduate Medical Centre (JPMC) with a big head, Occipitofrontal Circumference (OFC) 36 cm. She was admitted on 29th August 2007 and was discharged on 5th September 2007 from Jinnah Postgraduate Medical Centre after the management of moderate birth asphyxia. Cranial ultrasound revealed moderate Hydrocephalus (symmetrical) with prominent third ventricle. Treatment and its effectiveness have been discussed.展开更多
文摘We report a 27-year-old female who presented with abdominal distension, saddle anesthesia, and lower back pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Anterior approach was chosen, uterine didelphys was identified and mobilized, meningocele identified and gentle drainage with subsequent resection of the cyst wall and watertight closure was achieved. Subsequent MRI demonstrated resolution of most the sacral meningocele. Patient symptoms improved and are doing well.
文摘Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can occur with growth. Surgical treatment, in addition to avoiding rupture and correcting the aesthetic damage, will preserve neurological functions. We report 2 cases that we took care of. They are a 5-month-old infant and a 3-year-old girl. The first presented a 7 cm rounded meningocele pedunculated through the C1 lamina defect. The second presented an 8.6 cm polylobed meningocele pedunculated through the C2 lamina defect. They both underwent surgery with good progress.
文摘Asymptomatic intrapelvic meningocele is rare. Here, we report the case of a 30-year-old Chinese man who underwent sigmoidectomy due to megacolon. During the operation, an intrapelvic cyst was found and resected. Meningocele was confirmed by histological examination. The patient recovered well postoperatively with the ex- ception of liquorrhoea. Conservative therapy was initiated, including draining, anti-infection and specific posture maintenance. During the following week, liquorrhoea was generally relieved and the patient was discharged. This is the first known report of liquorrhoea associated with intrapelvic meningocele resection successfully treated by conservative therapy. Our case indicates that conservative treatment may be considered for similar cases so that a second surgery is avoided.
文摘Objective: The authors report a rare case of giant thoracic meningocele causing acute respiratory compromise, treated with a ventriculoperitoneal shunt. Case Report: We report the case of a 36-year-old with severe scoliosis status post repair over a decade ago, neurofibromatosis type I, and a known large meningocele in the left thoracic cavity, presenting with new acute respiratory compromise. She was taken to the operating room for a lumboperitoneal shunt, but the operation was aborted due to her severe spinal deformity. Two days later, she successfully underwent a procedure for ventriculoperitoneal shunt placement. Upon discharge a week later, the patient was hemodynamically stable, able to move all extremities with good strength, and demonstrated improved oxygenation. In the following 7 months, the patient demonstrated continued minimal requirement on nasal cannula, and MRI showed a stable left thoracic giant meningocele. Conclusion: Ventriculoperitoneal shunting is a method of treating and stabilizing acutely symptomatic giant meningoceles.
文摘Anterior sacral meningocele is characterized by the herniation of the thecal sac into the retroperitoneal space. A 33-year-old man was referred to our hospital with the complaints of a longlasting constipation and nonspecific lower abdominal pain. At ultrasound, a cystic mass was detected at the presacral space. Computed Tomography revealed a defect at the anterior aspect of the sacrum, together with a presacral cystic mass which showed a connection with the dural sac. At Magnetic Resonance Imaging, it was demonstrated that the cystic mass made an impression on the rectum, and did not possess any solid components. An anteroposterior pelvis radiogram demonstrated a sacral deformity and the scimitar sign. Upon these imaging findings, the patient got the diagnosis of an anterior sacral meningocele. The possibility of an anterior sacral meningocele must always be kept in mind in the differential diagnosis of a pelvic cystic mass.
文摘We report a 24-year-old male who presented with abdominal distension, constipation and left sided groin pain. CT and MRI of the abdomen/spine were performed which showed a large anterior sacral meningocele occupying most of the pelvic and abdominal cavity and displacement of their respective contents. Initially a posterior approach with lumbosacral laminectomy (L5 - S4) was performed. The ostium of the meningocele was identified with several nerve roots identified passing through, adjacent and into the defect. As nerve roots traversed the ostium, watertight closure was not feasible without sacrificing nerve roots. Subsequent MRI demonstrated recurrence of approximately 60% of the anterior sacral meningocele. We therefore opted to approach the ASM anteriorly via an anterior approach with the help of colorectal surgical colleague. The ASM was completely embedded within the sigmoid and upper to mid rectal mesentry, with its own vascular supply to the thick walled capsule. This case highlights the need for a combined approach due to the incorporation of the pseudomeningocele into the omentum with the development of its own blood supply.
文摘Spinal dermoid cysts are gradually progressive benign tumors that may be congenital or acquired. They account for 0.8% to 1.1% of all primary spinal tumors. MRI is the gold standard for the radiological assessment. Management is difficult for tumors involving highly eloquent areas such as the conus medullaris. In this report, we present a rare case of an adult woman with dermoid cysts in the conus medullaris associated with a sacral meningocele which was treated with a midline myelotomy that drained yellowish keratinous fluid and decompressed the cyst. No aggressive attempt at complete resection of the cyst wall was undertaken. The patient fully recovered, and her condition considerably improved after surgery and remains good at a 6-month follow-up.
文摘Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare.We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait ataxia.Magnetic resonance imaging revealed that a dorsal intradural extramedullary cystic lesion extended from T1 to T5 and compressed the spinal cord.A left lateral intrathoracic meningocele pouch was found incidentally at the level of T1.The arachnoid cyst as well as meningocele was removed and the spinal cord compression was relieved.Arachnoid cyst was confirmed by histological examination.The patient recovered well postoperatively.This is the second report of such a case in the world according to the available literature.The take-home message for our case is that the surgical approach should be individualized,depending on the size and location.
文摘A female infant, named Anum 1.8 kg was born on 9th August 2007 at Jinnah Postgraduate Medical Centre (JPMC) with a big head, Occipitofrontal Circumference (OFC) 36 cm. She was admitted on 29th August 2007 and was discharged on 5th September 2007 from Jinnah Postgraduate Medical Centre after the management of moderate birth asphyxia. Cranial ultrasound revealed moderate Hydrocephalus (symmetrical) with prominent third ventricle. Treatment and its effectiveness have been discussed.
