[Cervical meningocele with filiform connection. Case report]

Area of Science:

• Neurology
• Obstetrics and Gynecology
• Pediatric Surgery

Background:

• Meningocele, a rare form of spina bifida cystica (<10% of cases), presents unique diagnostic and management challenges.
• Risk factors identified in this case include unplanned pregnancy, uncontrolled first-trimester prenatal care, lack of folic acid supplementation, and parental consanguinity.
• The patient, a 26-year-old female with a history of two cesarean sections, presented for prenatal care late in gestation (34 weeks).

Observation:

• Prenatal ultrasonography revealed a posterior cervical meningocele with a filiform connection between the first and second cervical vertebrae.
• Associated findings included lateral ventriculomegaly, third and fourth ventricular dilation, and secondary hydrocephalus.
• A soft, 5x5 cm tumor with intact skin was noted in the posterior cervical region of the newborn male, born at 37 weeks gestation.

Findings:

• The newborn exhibited normal movement in all four extremities with no initial neurological deficits.
• Postnatal examination confirmed the cervical meningocele.
• The infant underwent shunt placement and subsequent surgical excision of the meningocele.

Implications:

• This case underscores the importance of prenatal diagnosis of rare congenital anomalies like cervical meningocele.
• Timely neurosurgical intervention, including shunt placement and tumor excision, is crucial for favorable outcomes in affected newborns.
• Further research into the genetic and environmental factors contributing to meningocele development is warranted.