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- Title
Retained medullary cord extending to a sacral subcutaneous meningocele.
- Authors
Murakami, Nobuya; Morioka, Takato; Shimogawa, Takafumi; Hashiguchi, Kimiaki; Mukae, Nobutaka; Iihara, Koji; Uchihashi, Kazuyoshi; Suzuki, Satoshi O.
- Abstract
Background: A retained medullary cord (RMC) is a rare closed spinal dysraphism with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac. One case extending down to the base of a subcutaneous meningocele at the sacral level has been reported.Clinical presentation: We report on three cases of closed spinal dysraphism, in which a spinal cord-like tethering structure extended out from the dural cul-de-sac and terminated at a skin-covered meningocele sac in the sacrococcygeal region, which was well delineated in curvilinear coronal reconstructed images of 3D-heavily T2-weighted images (3D-hT2WI). Intraoperative neurophysiology revealed the spinal cord-like tethering structure was nonfunctional, and histopathology showed that it consisted of central nervous system tissue, consistent with RMC. The tethering structure histologically contained a glioneuronal core with an ependymal-like lumen and smooth muscle, which may indicate developmental failure during secondary neurulation.Conclusions: When the RMC extending to a meningocele is demonstrated with the detailed magnet resonance imaging including 3D-hT2WI, decision to cut the cord-like structure for untethering of the nervous tissue should be made under careful intraoperative neurophysiological monitoring.
- Subjects
MESODERM; SPINA bifida; MYELOMENINGOCELE; SACROCOCCYGEAL region; URINARY tract infections
- Publication
Child's Nervous System, 2018, Vol 34, Issue 3, p527
- ISSN
0256-7040
- Publication type
Article
- DOI
10.1007/s00381-017-3644-2