Anterior cervical meningocele with craniovertebral junction instability – A case report and literature review

Abstract

Anterior meningocele involves herniation of meninges through an abnormal defect in the anterior vertebral column. The pathogenesis, natural history, and management strategy of anterior cervical meningocele (ACM) are uncertain. We report a case of ACM with high cervical instability in a case of neurofibromatosis 1. Unlike other reported cases, torticollis and instability due to ACM were the major concerns in this case. We aim to discuss the management strategy and surgical nuances of such cases.

Treatment of an anterior cervicothoracic myelomeningocele together with spine deformity correction in a child: illustrative case

“… 11 Kumar et al. 7 reported a case of a 19-year-old patient with NF1 who had an anterior upper cervical meningocele, C2–4 levoscoliotic deformity, and cerebellar pilocytic astrocytoma. She was managed with resection of the cerebellar astrocytoma and scoliosis correction with C1–4 lateral mass fixation without meningocele repair.…”

“…She was managed with resection of the cerebellar astrocytoma and scoliosis correction with C1–4 lateral mass fixation without meningocele repair. 7 …”

“…1,2 Cases of cervicothoracic meningocele or myelomeningocele have been reported predominantly in association with neurofibromatosis type 1 (NF1) and are thought to result from a combination of mesodermal dysplasia and dural ectasia in this neurocutaneous syndrome. [4][5][6][7] Mesodermal dysplasia results in bony defects, such as enlarged intervertebral foramina and scalloped vertebral bodies, through which the dysplastic meninges can herniate. 1,7 Patients often present with progressive neurological decline from the tethered cord, pulmonary dysfunction, dysphagia, and scoliosis.…”

Prenatal Diagnosis and Outcomes of Cervical Meningocele and Myelomeningocele

“…Rare types of cervical dysraphism include anterior and lateral cervical meningocele and double cervical and lumbosacral meningocele. Double cervical and lumbosacral meningocele can be identified during childhood,[ 26 27 ] whereas anterior and lateral cervical meningocele is mainly diagnosed in adulthood, except for a few cases in which meningocele was detected in newborns with torticollis. [ 28 ] Neurofibromatosis, an autosomal-dominant hereditary disease, is associated with mesodermal dysplasia and dural ectasia and is a risk factor for anterior cervical meningocele.…”

“…[ 28 ] Neurofibromatosis, an autosomal-dominant hereditary disease, is associated with mesodermal dysplasia and dural ectasia and is a risk factor for anterior cervical meningocele. [ 25 26 28 29 ]…”