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cervical meningocele

Wednesday 21 December 2011

Cervical meningoceles are tethering lesions of the spinal cord that may cause biomechanical injury with repetitive flexion-extension movements of the head and spine. It is therefore advisable to remove these lesions neurosurgically as soon as the diagnosis is made.

The goals of surgical exploration of these lesions are prevention of neurological deterioration, prevention of infection, and acceptable cosmetic outcome.

Surgical intervention for cervical meningoceles should consist of exploration of the intradural fibrous bands with laminectomy, untethering of the spinal cord, and resection of the stalk and cyst of the meningocele.

Myeloschisis

Myeloschisis is a distinctive form of spinal dysraphism characterized by 2 constant features: a focal "closed" midline defect and a fibroneural stalk that links the skin lesion to the underlying cord.

The embryogenesis is hypothesized to be incomplete disjunction between cutaneous and neural ectoderms, thus preventing complete midline skin closure and allowing persistence of a physical link (fibroneural stalk) between the disjunction site and the dorsal neural tube.

References

- Limited dorsal myeloschisis: a distinctive clinicopathological entity. Pang D, Zovickian J, Oviedo A, Moes GS. Neurosurgery. 2010 Dec;67(6):1555-79; PMID: 21107187

- Cervical congenital midline meningoceles in adults. Duz B, Arslan E, Gönül E. Neurosurgery. 2008 Nov;63(5):938-44; discussion 944-5. PMID: 19005384