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Infant Rudimentary Meningocele with Tethering of the Cervical Cord: A Case Report
Regan M Shanahan1, Joseph S Hudson1, Sakibul Huq1
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Insights
Rudimentary meningoceles, a rare spinal condition, can cause tethered spinal cords in infants. Surgical excision is crucial for preventing neurological deficits and infection.
Area of Science:
- Pediatric Neurosurgery
- Spinal Dysraphism
- Congenital Malformations
Background:
- Rudimentary meningoceles are rare spinal malformations.
- Dural extension necessitates surgical intervention in pediatric patients.
- Early diagnosis and treatment prevent neurological deficits.
Observation:
- A 5-month-old infant presented with a tethered spinal cord due to a rudimentary meningocele.
- Clinical presentation included a midline cervical dimple, suggestive of a dermal sinus tract.
- MRI revealed a sinus tract with intradural extension and an external opening.
Findings:
- En bloc surgical excision and spinal cord release were successfully performed.
- Histological analysis confirmed rudimentary meningocele with two blunt sinus tracts.
- The procedure effectively addressed the spinal cord tethering.
Implications:
- Surgical intervention is effective for intradural rudimentary meningoceles in infants.
- Early surgery prevents motor complications associated with spinal cord tethering.
- Excision mitigates risks of neoplastic growth within the meningocele.
Abstract:
Rudimentary meningoceles of the spine with dural extension are very rare and warrant surgical excision to prevent infection and long-term neurological deficits in pediatric patients. We present the case of a 5-month-old infant with a tethered spinal cord secondary to a rudimentary meningocele. The patient presented shortly after birth with a midline cervical dimple that was evaluated for a suspected dermal sinus tract. Magnetic resonance imaging scan of the spine showed a sinus tract with intradural extension to C2-3 and external opening at the level of spinous process C5. En bloc surgical excision and spinal cord release were successfully performed. Histological analysis of the specimen confirmed the presence of two blunt sinus tracts and staining was consistent with a rudimentary meningocele. Intradural rudimentary meningoceles in infants can successfully be managed with surgical intervention. Surgery is indicated to prevent future motor complications from spinal cord tethering and neoplastic growth from the rudimentary meningocele.
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