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      Role of screening of whole spine with sagittal MRI with MR myelography in early detection and management of occult intrasacral meningocele

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          Abstract

          Objective:

          We evaluated the role of screening of the whole spine by sagittal magnetic resonance imaging (MRI) along with MR myelography in early detection and management of occult intrasacral meningocele.

          Materials and Methods:

          A prospective and retrospective analysis of MRI and MR myelography studies of the whole spine over a period of one year was performed.

          Results:

          Thirty cases with sacral meningeal cysts were seen. On MRI, six patients (three males, three females) fulfilled the criterion of occult intrasacral meningocele. These patients showed a cyst of cerebrospinal fluid (CSF) signal intensity in the sacral canal below the dural sac. This cyst communicated with the thecal sac through a narrow pedicle. Fat signal intensity in the filum terminale and occult sacral dysraphism in the form of an absent or hypoplastic neural arch was observed in all the patients. Low-lying conus medullaris with thick filum terminale was seen in five of these six patients. Excision of the cyst with the release of filum was performed in two patients with a favorable outcome.

          Conclusion:

          Screening MRI with MR myelography of the whole spine may play a role in the early detection and management of occult intrasacral meningocele. The commonly associated thick filum terminale and low-lying conus medullaris may be missed otherwise that may lead to a progression of symptoms.

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          Author and article information

          Journal
          Asian J Neurosurg
          Asian J Neurosurg
          AJNS
          Asian Journal of Neurosurgery
          Medknow Publications & Media Pvt Ltd (India )
          1793-5482
          2248-9614
          Oct-Dec 2013
          : 8
          : 4
          : 174-178
          Affiliations
          [1]Department of Radiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
          [1 ]Department of Pathology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
          [2 ]Department of Neurosurgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
          Author notes
          Address for correspondence: Dr. Rajiv Azad, Department of Radiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India. E-mail: rajivas23@ 123456yahoo.com
          Article
          AJNS-8-174
          10.4103/1793-5482.125660
          3912767
          b4adbabd-6672-4c9f-94cb-7e419582be0e
          Copyright: © Asian Journal of Neurosurgery

          This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

          History
          Categories
          Original Article

          Surgery
          mr,myelography,occult meningocele
          Surgery
          mr, myelography, occult meningocele

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