The occult intrasacral meningocoele

The Intrasacral Meningocele

“…Nine of these patients also had an MRI scan. Seven patients were men and four women in the ratio of 2:1, as demonstrated in other studies 14 . Age varied from 21 to 62 years.…”

“…CT study with intrathecal injection of water-soluble contrast medium may be available to confirm that we are dealing with a meningeal diverticulum and to improve the anatomical demonstration of the lesion and better define its relation to adjacent structures 5,[7][8][12][13][14]17 . Contrast-enhanced images will exclude tumours and other cystic lesions such as perineural Tarlov's cysts arising in the space between the perineurium and endoneurium.…”

“…The most common are: disturbances of sphincter function; hypoaesthesia or anaesthesia in the lower sacral dermatomes; low back and sciatic pain that usually become progressively more constant and severe; absence of the ankle jerks and motor impairment related to lumbar or sacral root compression. Some patients complain of headache on straining due to a sudden increase in intracranial pressure 1,2,6,[12][13][14][15]17 .…”

“…Initially the meningocele is roundish with dimensions between 0.5 and 2 cm and located in the sacral region. The hydrostatic pressure, pulsations of cerebrospinal fluid or the high protein content of the fluid within the cavity tend to dilate the sac with time and produce local erosion of the sacrum and lower lumbar vertebrae 14 . The diverticulum penetrates the adjacent regions through the anatomical openings of the sacrum or eventually leads to associated secondary bone erosions 2,8,12,17 .…”

“…The intrasacral meningocele (also called occult intrasacral meningocele) is an intrathecal cystic formation arising as a protrusion of the arachnoid through a congenitally weak place in the dura mater 1,2,6,[12][13][14] . This meningeal diverticulum arises at the end of the thecal sac and is continuous with the lower subarachnoid space through a narrow neck 4 .…”