Lumbosacral Meningocele in Adulthood

Year 2015, , 131 - 135, 09.10.2015

Nuriye Özdemir İbrahim Atcı Veysel Antar Hakan Yılmaz , Gorkem Bıtırak Salim Katar Kaya Kılıç

https://doi.org/10.17826/cutf.59425

Abstract

Spinal dysraphism is the incomplete fusion of the neural arch, which can be seen as an occult or open neural tube defect. Meningoceles are a form of open neural tube defect and characterized by cystic dilatation of the meninges containing cerebrospinal fluid (CSF), without the involvement of neural tissue. These lesions are often benign and typically diagnosed at birth. Neurosurgical intervention is necessary in the newborn period, since survival in advancing ages is often impossible. Therefore, meningoceles are rarely reported among spinal dysraphic lesions in adulthood. They are tethering lesions of the spinal cord, adhering to the dura and other soft tissues with fibrous elements. In addition, the caudal lesions tend to leak CSF, unlike cervical congenital midline meningoceles. Here, we present a 41 year-old female patient with a meningocele that has developed CSF leakage. The clinical course, surgical management, and follow-up period of this rarely seen adulthood meningocele are also discussed.

Keywords

Adulthood, meningocele, spinal dysraphism

Erişkinde Lumbosakral Meningosel

Abstract

Spinal disrafizm nöral arkın kapalı veya açık nöral tüp defekti şeklinde görülen inkomplet füzyonudur. Meningoseller açık nöral tüp defektleri olup meninkslerin içi beyin omurilik sıvısı (BOS) dolu ve nöral doku içermeyen kistik dilatasyonları olarak görülürler. Doğum sırasında tespit edilen benign lezyonlardır. Uzun yaşam süresi ile bağdaşmayacağından, meningosele yönelik cerrahi girişim hemen yenidoğan periyodunda yapılmalıdır. Meningoseller erişkin spinal disrafik lezyonlar arasında nadiren rapor edilmiştir. Duraya ve diğer yumuşak dokulara fibröz bantlarla yapışarak spinal kordu gererler. Servikal konjenital orta hat meningosellerinin aksine kaudal yerleşimli lezyonlar genellikle BOS sızıntısına neden olurlar. Lezyon yerinden BOS sızıntısıyla başvuran 41 yaşındaki kadın meningosel olgusunu rapor ediyoruz. Klinik gidişat, cerrahi yaklaşım ve ameliyat sonrası takip sürecindeki müdahaleler tartışılmıştır.

Keywords

Erişkin, meningosel, spinal disrafizm

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