Intrathoracic Meningocele

Thoracic and lumbar meningocele in neurofibromatosis type 1. Report of two cases and review of the literature

We report two cases of ventrolateral thoracic and lumbar meningoceles associated with neurofibromatosis type 1, and present a review of the literature. Thoracic and lumbar meningoceles are rare lesions which are associated with neurofibromatosis in 60% to 85% of cases. Large meningoceles may cause pain, neurological signs, or respiratory complaints when located intrathoracically. Surgery is indicated in such cases, as well as when small meningoceles enlarge with time. The etiology of meningoceles in neurofibromatosis remains controversial. The authors postulate that ventrolateral lesions of the thoracic and lumbar spine are secondary to congenital mesodermal dysplasia and hypoplastic bone changes. MRI is the diagnostic method of choice, since it most adequately visualizes the pathological anatomy of the spinal cord, meninges, and adjacent structures in every sectional plane. CT scans are particularly useful in assessing the spinal bony changes.

Lumbosacral dural anomalies in von Recklinghausen neurofibromatosis

The lumbosacral dural abnormalities in two patients with von Recklinghausen neurofibromatosis (vRNF) are described. Analysis of 18 previously reported cases revealed considerable morphological variations of the lumbosacral dural lesions associated with vRNF, but three basic forms may be distinguished. The pathogenesis of these lesions is still controversial. The contrast studies in our patients, especially the computed tomographic myelography (CTM), suggest that the meningocoeles in vRNF are, in fact, abnormally dilated and elongated nerve root sleeves and should, therefore, be distinguished from other types of meningeal cysts occurring in the lumbosacral region. The clinical significance of these dural anomalies are discussed.

Anterior sacral meningocele

A case of anterior sacral meningocele is presented emphasizing early diagnosis based on recurring functional complaints and employing appropriate radiological studies. The appropriate use of computerized tomography (CT) scanning and the proper surgical management utilizing laminectomy and obliteration of the communicating channel of the meningocele are discussed.

Spontaneous incarcerated herniation of the spinal cord into a vertebral body: a unique cause of paraplegia. Case report

✓ A case of progressive paraparesis is reported in which the normal spinal cord herniated through a defect in the ventral meninges and dura and became incarcerated in a cavity in the dorsal aspect of the body of T-7. Progress of the paraparesis was arrested by reduction of the hernia.