Publique en esta revista
Información de la revista

Congreso

Contenidos del congreso
Congreso
XXII Congreso Nacional de la Sociedad Española de Neurocirugía
Toledo, 16-18 Mayo 2018
Listado de sesiones
Comunicación
34. HIDROCEFALIA
Texto completo

P0292 - ADULT OCCULT SACRAL MENINGOCELE: LOOK TO THE CRANIUM FIRST!

J. Esteban García, P. López Gómez, D. Suárez Fernández, I. Valduvieco Juaristi, J.Á. Martínez Agüeros and R. Martín Laez

Hospital Universitario Marqués de Valdecilla, Cantabria, Spain.

Objectives: To point out how important can additional ancillary diagnostic procedures be in the management of the adult occult sacral meningocele. We illustrate three representative cases and emphasize how certain spinal meningeal cysts may cover up CSF disturbances associated to more complex cranial conditions.

Methods: Our three patients presented with progressive radicular pain accompanied by bladder dysfunction. Lumbar MRI revealed an occult sacral meningocele in all cases. The first two patients were initially treated with microsurgical resection and dural reconstruction. Both experienced initial clinical relief but deteriorated progressively few months after. Over time, they complained of headache and dizziness. Brain MRI was ordered that showed partial empty sela in the first patient and tonsillar herniation in the second. In our third case brain MRI was directly ordered after the initial diagnosis.

Results: The patients underwent chronic ICP monitoring, two of them using the ICP Logger™ ambulatory system and the third with the ICP Station™ bed side ICP monitor. In all cases a chronic CSF circulation disturbance was diagnosed. The first case was managed with lumboperitoneal shunting, achieving complete relief of symptomatology. The second case required posterior fossa decompression followed by lumboperitoneal shunting, the same procedure planned for our third patient.

Conclusions: Association between spinal meningeal cysts with cranio-cervical junction diseases and CSF circulation disturbances is still not well documented. In fact, the presence of an altered CSF circulation may be under-diagnosed in these patients and cranial related symptomatology may only appear after the cyst is resected and the dura reconstructed. We suggest that a complete cranio-cervical MRI should be obtained to assess the presence of Chiari malformation or indirect signs of CSF circulation disturbance (i.e. partial empty sela). If such findings appear, ICP monitoring may be very helpful during the decision-making process, as sometimes the appropriate treatment may differ from the classical microsurgical treatment.

Idiomas
Neurocirugía

Suscríbase a la newsletter

es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.