Postoperative cardiorespiratory arrest in a case of cervical meningocele

Meningoceles are congenital herniation of meninges and cerebrospinal fluid (CSF) through the skull and are bereft of any cerebral tissue. They are commonly found over the anterior fontanelle. Although some cases of cervical dysraphism have been described in the literature, a true meningocele has rarely been seen. The child usually presents with hydrocephalus with features of raised increased intracranial pressure. Sensory, motor, and sphincter functions may be involved depending on the level of lesion. Closure of meningocele should be ideally done within the first 48 h of birth.

Complications associated with meningocele range from learning disabilities, seizures, and bowel dysfunction to complete paralysis below the level of the lesion. The postoperative complications reported are wound infection, CSF leak/collection, urinary tract infection, deterioration of deficit, and death. Here, we present a postoperative case of an 11-month-old child with cervical meningocele who had an unusual complication almost 2 h after an uneventful surgery in the form of sudden cardiorespiratory arrest was revived successfully.

A meningocele surgery is usually not associated with severe postoperative complications which can be encountered in meningomyelocele surgery. Here, in our case, the child with uneventful meningocele surgery arrested 2 h postsurgery with the possible cause being cervical cord edema. Hence, a lesson was learned that strict vigilance is also required in postoperative care for meningocele patients.