Rahimizadeh Abolfazl, Ahmadi Seyed Ali, Mohammadi Moghadam Ali, Rahimizadeh Shaghayegh, Williamson Walter, Amirzadeh Mahan, Hajaliloo Sami Sam
1Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran; and.
2Department of Pathology, Sina Hospital, Tehran University of Medical Science, Tehran, Iran.
J Neurosurg Case Lessons. 2023 Jun 5;5(23). doi: 10.3171/CASE23152.
Posterior cervical meningoceles are rare in adults because most are surgically excised early in life. Such meningoceles in adults are mostly presented as a cystic mass and their presentation as a solid mass is very rare.
An asymptomatic adult with cervical meningocele presented as a congenital midline skin covered solid mass in the posterior aspect of the neck is presented. Neuroradiological surveys showed attachment of the mass to intradural spinal cord. With diagnosis of a cervical meningocele, after excision of the solid sac, the stalk extending from the core of the mass to the dura was isolated. This was followed by intradural spinal cord detethering. The mass was compatible with rudimentary meningocele in pathology.
Neglected cervical meningocele is quite rare in adults. Surgical removal of the mass in adults is usually for cosmetic reasons rather than neurological impairment. However, surgical removal of the mass without intradural cord detethering is not sufficient. In such cases, late onset quadriparesis may be appear due to the spinal cord tethering scenario.
颈椎后位脑脊膜膨出在成人中较为罕见，因为大多数在生命早期就接受了手术切除。成人的此类脑脊膜膨出大多表现为囊性肿块，而表现为实性肿块的情况极为罕见。
本文报告了一例无症状的成年颈椎脑脊膜膨出患者，其表现为颈部后方先天性中线皮肤覆盖的实性肿块。神经放射学检查显示肿块与硬脊膜内脊髓相连。诊断为颈椎脑脊膜膨出后，在切除实性囊后，分离了从肿块核心延伸至硬脑膜的茎。随后进行了硬脊膜内脊髓松解术。该肿块在病理上与发育不全的脑脊膜膨出相符。
被忽视的颈椎脑脊膜膨出在成人中相当罕见。成人手术切除肿块通常是出于美容原因而非神经功能损害。然而，在未进行硬脊膜内脊髓松解的情况下手术切除肿块是不够的。在这种情况下，由于脊髓拴系情况，可能会出现迟发性四肢瘫。
