1. Turbulent Cerebrospinal Fluid Flow in Enlarging Terminal Myelocystocele.
- Author
-
Sprenger F, de Andrade JMC, and de Almeida Teixeira BC
- Subjects
- Anus, Imperforate physiopathology, Anus, Imperforate surgery, Disease Progression, Female, Hernia, Umbilical physiopathology, Hernia, Umbilical surgery, Humans, Infant, Infant, Newborn, Infant, Premature, Magnetic Resonance Imaging, Meningomyelocele physiopathology, Meningomyelocele surgery, Paraparesis physiopathology, Scoliosis physiopathology, Scoliosis surgery, Syringomyelia physiopathology, Syringomyelia surgery, Urogenital Abnormalities physiopathology, Urogenital Abnormalities surgery, Anus, Imperforate diagnostic imaging, Cerebrospinal Fluid diagnostic imaging, Hernia, Umbilical diagnostic imaging, Hydrodynamics, Meningomyelocele diagnostic imaging, Scoliosis diagnostic imaging, Syringomyelia diagnostic imaging, Urogenital Abnormalities diagnostic imaging
- Abstract
Terminal myelocystocele is a rare type of neural tube malformation, consisting of a skin-covered lumbosacral mass, highly associated with other complex abdominal malformations within the OIES complex (omphalocele, imperforate anus, exstrophy of the cloaca and spinal defects). We present a case of a premature female with an extensive lumbosacral mass at birth, as well as an omphalocele, cloacal exstrophy, renal abnormalities, and sacral agenesis. Lumbar magnetic resonance imaging revealed a meningocele sac herniating through the bone defects and containing a syringocele sac. Advanced imaging techniques showed turbulent cerebrospinal fluid flow. At control, 4 weeks later, the defect doubled in size. The myelocystocele sac was evacuated and closed, and the patient persisted with paraparesis. The role of cerebrospinal fluid flow analysis is well established in Chiari-type malformations, in which turbulent flow within the syrinx is related to a better outcome after surgery. It is possible that the same principle could be applied to other spinal malformations, as shown in this case of terminal myelocystocele., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF