[Anterior sacral meningocele. A report of one case demonstrated by tomo-scan (author's transl)].

The account of an anterior sacral meningocele, the clinical manifestation of which were cephalagia and urinary disorders. Radiologically, apart from partial agenesia of the terminal sacral segments, an IVU showed a crossed renal ectopia with horse-shoe kidney and a spectacular vesical displacement caused by extrinsic compression. The tomo-scan brought into evidence a voluminous, spreading pelvic processus attached to the spinal canal through a hiatus in the neuro-sacral arch. Clinically, semeiology was primarily a matter of the local effects caused by displacement of the abdomino-pelvic organs ; secondarily it concerned the neurological disorders resulting from compression of the nerve roots included in the cystic wall. As well as the "scimitar" appearance of the sacrum-considered to be pathognomonic - the radiological triad comprises a visualization of the communication between the spinal canal and the kystic pouch - obtained by myelography, preferably gaseous, in association with tomography, and lastly a demonstration by tomo-scan of the hiatus in the neuro-sacral arch. A trans-sacral surgical approach with elimination of the kyst by means of closing off the neck without total excision of the pouch is the most indicated treatment.