Cervical Meningocele Causing Symptoms in Adulthood

Abstract

Simple meningoceles are infrequent forms of dysraphism and are often benign. These lesions are usually associated with other congenital spinal anomalies, and are typically diagnosed in childhood. Most become symptomatic in childhood because of progressive spinal cord or nerve root tethering. This article describes the case of a 47-year-old man who presented with a sac in his posterior cervical region that had been leaking colorless fluid for 3 months. He was also having difficulty walking and complained of stiffness in his lower extremities. Cervical magnetic resonance imaging revealed a cystic mass in the region of the C4 to C5 laminae. Partial laminectomies were performed (lower portion C4 lamina, upper portion C5 lamina), the sac was totally excised, and tissue tethering the spinal cord were cut. There was no recurrence of symptoms in 12 months of follow-up. Although in cases where a cervical meningocele-myelomeningocele is detected at any time, early treatment is essential to eliminate the high risk of future neurological impairment. This is the first report of an untreated cervical meningocele manifesting symptoms in adulthood.

Missed limited dorsal myeloschisis: an unfortunate cause for recurrent tethered cord syndrome

“…Some of these are present in adulthood, as in our third case, and such cases abound in the medical literature [17][18][19][20].…”

Cervical myelocystocele: Case report and review of literature

“…However, several case reports have documented tethering in cMMCs which presents as neurological deterioration in the future. [12–14] The role of imaging in asymptomatic cervical spinal dysraphisms has been emphasized in literature. [31516] Magnetic resonance imaging is the modality of choice in these lesions, which helps to distinguish the subtypes of cMMC[15] and to identify the associated anomalies of central nervous system like hydrocephalus, split cord malformations, tethering, syringomyelia and chiari malformations.…”

Cervical (Non-terminal) Myelocystocele Associated With Rapidly Progressive Hydrocephalus and Chiari Type II Malformation -Case Report-

“…However, some patients developed delayed neurological symptoms due to tethering without closure of the sac, so early sac closure is now recommended. 5,7) Furthermore, simple ligation and resection of the sac is associated with the postoperative development of symptoms such as hand weakness or paraparesis due to tethering, so creation of a wide opening, exploration of the cervical canal, and definitive untethering is currently recommended. 9) The reported anomalies associated with cervical meningocele that are as follows: hydrocephalus, Chiari type II malformation, hydromyelia, lipomyelomeningocele, tethered cord, thickened filum terminale, diastematomyelia, Klippel-Feil syndrome, and thoracic hemivertebrae.…”