CASE 929 Published on 25.02.2001

Simple Meningocele

Section

Paediatric radiology

Case Type

Clinical Cases

Authors

E.P. Stuifzand, F.J.A. Beek, W.P. Vandertop

Patient

1 days, male

Categories
No Area of Interest ; Imaging Technique Ultrasound, MR
Clinical History
Small soft skin-covered back mass in the lumbosacral area at birth. No neurological symptoms.
Imaging Findings
A newborn male presented at birth with a small soft skin-covered back mass in the lumbosacral area. There were no evident neurological symptoms. Further evaluation included conventional radiographs of the spine, ultrasonography and MRI of the lumbosacral region.
Discussion
A meningocele is a herniated sac of meninges (dura and arachnoid) filled with CSF protruding through a bony defect in the spine or skull. By definition, a simple meningocele does not contain neural tissue. Meningoceles are a form of spinal dysraphism. Spinal dysraphism (SD) is defined as an incomplete or absent fusion of the posterior midline structures of the spine. Several vertebral levels may be involved. Three categories of SD are distinguished: SD with a non-skin-covered back mass, SD with a skin-covered back mass and occult SD. Due to congenital anomalies of the spinal cord and cauda equina some types of SD may lead to progressive deformities of the feet in children. Spina bifida occulta is the simplest form and consists of failure of fusion of the posterior neural arch of one or more vertebrae, most often L5 and S1-S2. At the latter location it is so common that it may be regarded as a normal variant in an asymptomatic patient. Occasionally patients with occult SD may not develop symptoms until later in adult life. The simple posterior meningocele associated with a skin-covered back mass is a relatively rare manifestation of SD. It consists of a herniated sac of meninges, filled with CSF and protruding through a bony defect in the spine. This defect is usually confined to one or two vertebrae and occurs most frequently in the lumbosacral region. There is no sex predilection. The conus medullaris may be low or normal in position, which is easily shown by ultrasonography or MRI. Conventional radiographs of the spine usually show widening of the spinal canal and increased interpedicular distance. Later views of the spine often disclose underdevelopment of the spinous processes and a posterior soft tissue mass.
Differential Diagnosis List
Simple meningocele
Final Diagnosis
Simple meningocele
Case information
URL: https://www.eurorad.org/case/929
DOI: 10.1594/EURORAD/CASE.929
ISSN: 1563-4086