scholarly journals Neurosurgical management in lateral meningocele syndrome: case report

2017 ◽  
Vol 19 (2) ◽  
pp. 232-238 ◽  
Author(s):  
Erik C. Brown ◽  
Kunal Gupta ◽  
Christina Sayama
Keyword(s):  
Connective Tissue ◽  
Chiari Malformation ◽  
Morphological Changes ◽  
Connective Tissue Disorder ◽  
Spinal Nerve ◽  
Flow Dynamics ◽  
Third Ventriculostomy ◽  
Csf Flow ◽  
Motor Weakness ◽  
Similar Patient

Lateral meningocele syndrome (LMS) is a rare genetic connective tissue disorder. It is associated with morphological changes similar to those of other connective tissue disorders, with the unique distinction of multiple, often bilateral and large, lateral meningoceles herniating through the spinal foramina. In some cases, these lateral meningoceles can cause pain and discomfort due to their presence within retroperitoneal tissues or cause direct compression of the spinal nerve root exiting the foramen; in some cases compression may also involve motor weakness. The presence of lateral meningoceles imposes unique challenges related to CSF flow dynamics, especially with concurrent Chiari malformation, which also occurs with increased frequency in individuals with LMS. The authors present the case of a 6-month-old female with LMS with multiple lateral meningoceles throughout the thoracic and lumbar spine. The infant experienced a focal neurological abnormality due to enlargement of her lateral meningoceles following decompression of a symptomatic Chiari malformation and endoscopic third ventriculostomy. The finding was reversed through implantation of a ventriculoperitoneal shunt, which reduced the burden of CSF upon the lateral meningoceles. Such a case compels consideration that CSF flow dynamics in addition to altered connective tissue play a role in the presence of lateral meningoceles in patients within this and similar patient populations.

Chiari malformation: CSF flow dynamics in the craniocervical junction and syrinx

2005 ◽  
Vol 147 (12) ◽  
pp. 1223-1233 ◽  
Author(s):  
D. E. Sakas ◽  
S. I. Korfias ◽  
S. C. Wayte ◽  
D. J. Beale ◽  
K. P. Papapetrou ◽  
...  
Keyword(s):  
Chiari Malformation ◽  
Craniocervical Junction ◽  
Flow Dynamics ◽  
Csf Flow

scholarly journals Chiari malformation and spinal interdural cyst: A proposed association and review of the literature

2021 ◽  
Vol 12 ◽  
pp. 626
Author(s):  
Raj Thakrar ◽  
Bruce Tranmer ◽  
Paul Penar
Keyword(s):  
Chiari Malformation ◽  
Treatment Options ◽  
Flow Dynamics ◽  
Review Of The Literature ◽  
Csf Flow ◽  
Csf Diversion ◽  
Unclear Etiology ◽  
Lumbar Cerebrospinal Fluid ◽  
Meningeal Cysts ◽  
Mass Lesions

Background: Interdural cysts are rare meningeal cysts with an unclear etiology. They are often mistaken for other mass lesions, including arachnoid cysts and tumors. Correctly identifying and classifying these cysts, as well as how they have formed in individual patients, are crucial to providing effective treatment options for patients. Case Description: We report a case of a patient with shunted idiopathic intracranial hypertension who developed a symptomatic Chiari malformation and was subsequently discovered to have a spinal interdural cyst. The Chiari malformation was likely due to intracranial hypotension secondary to lumbar cerebrospinal fluid (CSF) diversion. Once the shunt was removed, a spinal interdural cyst became clinically and radiographically evident, and the Chiari resolved, suggesting that both entities were effects of shared CSF flow dynamics. Conclusion: This cyst likely originated due to the trauma from remote repeated lumbar punctures and lumboperitoneal shunt placement, allowing CSF to enter the interdural space after the catheter was removed.

scholarly journals Assessment of Cerebrospinal Fluid Hydrodynamics Using Magnetic Resonance Imaging in Postcraniospinal Surgery Patients

2021 ◽  
Author(s):  
Pankaj Arora ◽  
Kanica Rawat ◽  
Rajiv Azad ◽  
Kehkashan Chouhan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Phase Contrast ◽  
Flow Dynamics ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Group I ◽  
Group Ii

Abstract Objective Aim of this study is to evaluate the effect of craniospinal interventions on cerebrospinal fluid (CSF) flow hydrodynamics and study the correlation of postoperative changes in flow alteration with clinical outcome. Materials and Methods Fifty patients who underwent various craniospinal procedures were studied using conventional and phase-contrast magnetic resonance imaging (PCMRI) protocol. CSF flow quantification was performed at cerebral aqueduct, foramen magnum, C2–3, and D12–L1 vertebral levels with site showing maximal alteration of CSF flow dynamics considered as the region of interest. Velocity encoding was kept at 20 cm/s. Patients with pathology atcraniovertebral junction were considered separately (group I) from others (group II) due to different flow dynamics. Follow-up scans were performed after an interval of 1 month for temporal evaluation of changes in CSF flow dynamics. Results Patients in both groups showed a significant change in peak CSF velocity postoperatively (mean change of 1.34 cm/s in group I and 0.28 cm/s in group II) with bidirectional improvement in flow on cine-phase-contrast qualitative images. Regional pain (82%) and headache (46%) were seen in most of the patients preoperatively. Postoperatively clinical symptoms improved in 59.5%, static in 26.2%, and worsened in 14.3%. In both the groups, an improvement in clinical symptomatology had significant correlation with mean changes in peak CSF velocity postoperatively (p = 0.04 in both groups). Conclusion PCMRI can effectively evaluate changes in CSF flow noninvasively both pre- and postoperatively. This may have potential role in determining clinical outcome and prognosis of patients undergoing procedures in craniospinal axis.

scholarly journals Atypical presentation of rheumatoid arthritis: a case of massive bilateral pleural effusions in a patient with Caplan syndrome

2019 ◽  
Vol 12 (10) ◽  
pp. e231899
Author(s):  
Yinglun Wu ◽  
Philip C Dittmar
Keyword(s):  
Rheumatoid Arthritis ◽  
Atrial Fibrillation ◽  
Pleural Effusion ◽  
Connective Tissue ◽  
Minimal Change Disease ◽  
Connective Tissue Disorder ◽  
Minimal Change ◽  
Atypical Presentation ◽  
Pleural Effusions ◽  
Recent Treatment

Rheumatoid arthritis (RA) is a common connective tissue disorder affecting the synovial joints. In patients with RA, involvement of the lungs occurs in 30%–40% of cases while pleural effusions occur in only 3%–5%. However, the majority of RA-associated pleural effusions are small, unilateral and asymptomatic. We present a case of massive bilateral pleural effusions in a patient with established rheumatoid pneumoconiosis (Caplan syndrome). Interestingly, the pleural effusion occurred following recent treatment for minimal change disease and atrial fibrillation.

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