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Journal of Neurosurgery. Spine Sep 2017Neurofibromatosis Type 1 (NF1) is a neurocutaneous disorder that can have associated spinal abnormalities related to both bone and dural dysplasia. Thoracic meningoceles...
Neurofibromatosis Type 1 (NF1) is a neurocutaneous disorder that can have associated spinal abnormalities related to both bone and dural dysplasia. Thoracic meningoceles are one spine anomaly associated with NF1, although they are a fairly uncommon pathology. Surgical techniques to treat these meningoceles, usually undertaken only when the patient is symptomatic, are targeted at decreasing the size of the protrusion and improving lung capacity. Surgical interventions discussed in the literature include shunting the pseudomeningocele, primary repair with laminectomy, thoracoscopic plication, and reinforcement of the closure with cement, muscle, or fascia. Authors here report the case of a 43-year-old woman with NF1 with worsening pulmonary function tests and in whom shunting of the pseudomeningocele failed. Subsequently, a posterolateral thoracotomy was performed. The dura mater was reconstructed and primarily closed. On this closure a Gore-Tex soft-tissue patch was placed along with polypropylene mesh and Evicel fibrin sealant, followed by titanium mesh. At the end of the procedure, a chest tube was left in place and therapeutic pneumoperitoneum was performed to decrease the dead space as the lung did not fully expand with positive-pressure ventilation. The patient's pulmonary function tests improved after the procedure. Thoracic meningoceles are uncommon and difficult pathologies to treat surgically. Although shunting is arguably the least invasive surgical option, it can fail in some patients. When it does fail, there are other options that require a multidisciplinary approach and careful attention to the dural closure and reinforcing layers.
Topics: Adult; Dura Mater; Female; Humans; Meningocele; Neurofibromatosis 1; Plastic Surgery Procedures; Reoperation; Thoracotomy
PubMed: 28621617
DOI: 10.3171/2017.2.SPINE16699 -
Ultrasound in Obstetrics & Gynecology :... Nov 2007We describe the case of a young woman with anterior sacral meningocele (ASM), initially identified during a routine ultrasound examination and subsequently diagnosed...
We describe the case of a young woman with anterior sacral meningocele (ASM), initially identified during a routine ultrasound examination and subsequently diagnosed using magnetic resonance imaging (MRI). ASM is a rare disorder characterized by uni- or multilocular extensions of the meninges from the sacral spinal canal to the retroperitoneal presacral space. Common symptoms include lower back and pelvic pain, constipation, difficulties in defecation, dysmenorrhea and dyspareunia, and urinary incontinence, retention or urgency. Perineal and lower-extremity paresthesias may present when nerve roots are affected. Despite its more posterior location, ASM can mimic an ovarian cyst or other adnexal cystic mass, and in the obstetric patient can present a mechanical obstacle to delivery with a risk of rupture and infection during labor and delivery. Although it is a rare condition, we feel that awareness of the etiology, presentation and imaging characteristics of ASM is of importance and have therefore carried out a review of the literature, taking into account case findings and the obstetric and gynecological management of this disorder.
Topics: Adult; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Meningocele; Ovarian Cysts; Sacrum; Treatment Outcome; Ultrasonography
PubMed: 17787029
DOI: 10.1002/uog.4061 -
Australian Veterinary Journal Apr 1998
Topics: Animals; Female; Meningocele; Postoperative Care; Sheep; Sheep Diseases; Skull
PubMed: 9612544
DOI: 10.1111/j.1751-0813.1998.tb10151.x -
American Journal of Medical Genetics.... Jul 2013Lateral meningocele syndrome is a rare disorder of unknown etiology, first described in 1977 and subsequently reported in nine other patients. These patients present...
Lateral meningocele syndrome is a rare disorder of unknown etiology, first described in 1977 and subsequently reported in nine other patients. These patients present distinctive craniofacial features and skeletal abnormalities in addition to multiple lateral meningoceles, suggesting a connective tissue disorder. Autosomal dominant inheritance is clearly suggested in one family and could explain familiar aggregation in another. We describe a simplex case of lateral meningocele syndrome with bicuspid aortic valve, supporting the hypothesis of a connective tissue basis for this disorder and further expanding the phenotype.
Topics: Abnormalities, Multiple; Aortic Valve; Bicuspid Aortic Valve Disease; Child, Preschool; Connective Tissue; Face; Female; Heart Valve Diseases; Humans; Infant, Newborn; Karyotyping; Magnetic Resonance Imaging; Male; Meningocele; Pregnancy
PubMed: 23696373
DOI: 10.1002/ajmg.a.35968 -
Clinical Neurology and Neurosurgery Nov 2021Thoracic meningoceles and dural ectasia are less commonly recognized manifestations of neurofibromatosis 1 (NF1). Rarely, large thoracic meningoceles may become...
Thoracic meningoceles and dural ectasia are less commonly recognized manifestations of neurofibromatosis 1 (NF1). Rarely, large thoracic meningoceles may become compressive and lead to respiratory compromise secondary to lung compression. Surgical goals aim to increase lung aeration through decreasing the size of the meningocele through shunting, excision or repair of the meningocele, and varying degrees of dural tube reconstruction. There is no agreement on the best approach for large, symptomatic meningoceles. Here, we discuss the case of a 41-year-old woman with NF1 who presented with dyspnea and enlargement of a large, 19 cm thoracic meningocele. A multidisciplinary team of thoracic, plastic, and neurological surgery participated in the operation to excise the meningocele and reconstruct the dural tube without the need for subsequent shunting of spinal fluid. We also systematically review the literature on thoracic meningoceles in NF1 to understand the optimal treatment of this pathology.
Topics: Adult; Female; Humans; Meningocele; Neurosurgical Procedures; Thoracic Vertebrae; Thoracotomy
PubMed: 34739882
DOI: 10.1016/j.clineuro.2021.106996 -
Archives of Pediatrics & Adolescent... Jun 2010
Topics: Child; Female; Humans; Meningocele
PubMed: 20530310
DOI: 10.1001/archpediatrics.2010.68-a -
Neurologia Medico-chirurgica Apr 2003A 25-year-old male presented with an anterior sacral meningocele (ASM) manifesting as repeated urinary tract infections. Surgical correction was completed by simple...
A 25-year-old male presented with an anterior sacral meningocele (ASM) manifesting as repeated urinary tract infections. Surgical correction was completed by simple ligation of the thecal sac next to the ostium via sacral laminectomy, and the thickened filum terminale was sectioned. A 22-year-old female presented with an ASM manifesting as transient difficulty in micturition. Subsequent to sacral laminectomy, the thickened filum terminale was sectioned. However, an aberrant nerve root over the ostium made simple ligation hazardous, so that transdural suture around the ostium was carried out. Complete obliteration was confirmed 5 months after the surgery. Magnetic resonance (MR) imaging could clearly demonstrate the involvement of neurologically important structures. Surgical strategy for ASM based on neurosurgical considerations is proposed, because of the frequent association of caudal spinal cord anomaly as well as presacral mass lesion. Intraoperative assistance systems such as endoscopy for cyst content examination and neurophysiological monitorings are recommended. Several months follow up with MR imaging is required to confirm successful surgical correction.
Topics: Adult; Female; Humans; Magnetic Resonance Imaging; Male; Meningocele; Neurosurgical Procedures; Sacrum; Spinal Cord Diseases
PubMed: 12760501
DOI: 10.2176/nmc.43.204 -
European Archives of... 2000We present a case of a 29-year-old female complaining of right-sided watery nasal discharge. Radiological investigations identified an intrasphenoidal meningocele. The...
We present a case of a 29-year-old female complaining of right-sided watery nasal discharge. Radiological investigations identified an intrasphenoidal meningocele. The origin of the meningocele was pinpointed to the right parasellar region and was confirmed surgically. The parasellar bony defect appeared to be due to persistence of the lateral craniopharyngeal canal (Sternberg's canal). Therefore, we assume a congenital origin for the intrasphenoidal meningocele found in the patient. Acquired bony defects of the sphenoid sinus are unlikely at the fusion planes of the different sphenoid bone components. Knowledge of the complex ontogeny of the sphenoid bone is an important key to differentiating between congenital and acquired sphenoid sinus meningoceles.
Topics: Adult; Cerebrospinal Fluid Rhinorrhea; Exudates and Transudates; Female; Humans; Meningocele; Sphenoid Bone; Tomography, X-Ray Computed
PubMed: 11073192
DOI: 10.1007/s004050000235 -
The Veterinary Record Feb 1998
Topics: Animals; Cattle; Cattle Diseases; Iran; Meningocele; Surgery, Veterinary; Treatment Outcome
PubMed: 9507651
DOI: 10.1136/vr.142.6.145 -
Internal Medicine (Tokyo, Japan) Aug 2003
Topics: Humans; Magnetic Resonance Imaging; Male; Meningocele; Middle Aged; Neurofibromatoses; Thorax
PubMed: 12924511
DOI: 10.2169/internalmedicine.42.767