Erol Fatih Serhat, Topsakal Cahide, Ozveren M Faik, Akdemir Ismail, Cobanoglu Bengu
Department of Neurosurgery, Firat University School of Medicine, Norosirurji Anabilim Dali, Elazig, Turkey.
Yonsei Med J. 2004 Jun 30;45(3):568-72. doi: 10.3349/ymj.2004.45.3.568.
Dermoid sinuses and meningoceles are seldom encountered in the cervical region. Besides, to the best of our knowledge, the coexistence of these types of congenital abnormalities with recurrent meningitis, as well as with mirror movement, has never been reported before. A 14-year-old female with the diagnosis of recurrent meningitis was referred to our clinic from the Department of Infectious Diseases. She had a cervical meningocele mass that was leaking cerebro-spinal fluid (CSF) and an associated mirror movement symptom. Spina bifida, dermoid sinus and meningocele lesions were demonstrated at the C2 level on computed tomography (CT) and magnetic resonance imaging (MRI). She underwent an operation to remove the sinus tract together with the sac, and at the same time the tethered cord between the sac base and the distal end of the spinal cord was detached. The diagnosis of dermoid sinus and meningocele was confirmed histopathologically. These kinds of congenital pathologies in the cervical region may also predispose the patient to other diseases or symptoms. Herein, a case of meningocele associated with cervical dermoid sinus tract which presented with recurrent meningitis and a rare manifestation of mirror movement is discussed. Neurosurgeons should consider the possible coexistence of mirror movement and recurrent meningitis in the treatment of these types of congenital abnormalities.
皮样窦和脑脊膜膨出在颈部很少见。此外，据我们所知，这些类型的先天性异常与复发性脑膜炎以及镜像运动并存的情况此前从未有过报道。一名诊断为复发性脑膜炎的14岁女性从传染病科转诊至我们的诊所。她有一个颈脑脊膜膨出肿块，伴有脑脊液漏，还有相关的镜像运动症状。计算机断层扫描（CT）和磁共振成像（MRI）显示C2水平存在脊柱裂、皮样窦和脑脊膜膨出病变。她接受了手术，切除了窦道和囊袋，同时分离了囊袋底部与脊髓远端之间的脊髓栓系。皮样窦和脑脊膜膨出的诊断经组织病理学证实。颈部的这类先天性病变也可能使患者易患其他疾病或出现其他症状。在此，讨论一例伴有颈皮样窦道的脑脊膜膨出病例，该病例表现为复发性脑膜炎和一种罕见的镜像运动表现。神经外科医生在治疗这类先天性异常时应考虑镜像运动和复发性脑膜炎可能并存的情况。
