| Abstract | BACKGROUND: Thoracic meningoceles are associated with neurofibromatosis 1 in 60% to 85% of all cases. Usually, these meningoceles remain asymptomatic, but back pain, headache, cough, and dyspnea are possible manifestations. Often, there is an associated kyphoscoliotic deformity of the thoracic spine. CASE DESCRIPTION: A 60-year-old woman known in our department after a fossa posterior decompression for an Arnold-Chiari malformation was admitted through the emergency department because of progressive dyspnea. A giant intrathoracic meningocele was already diagnosed earlier but was left untreated because the patient was asymptomatic at that time. She now had dyspnea, and on chest x-ray and CT scan, there was an obvious shift of the mediastinum to the right. Because of the long-existing hemithoracic meningocele, we assumed that this patient actually had only 1 functional lung, and so, left-sided thoracotomy with resection of the meningocele and closure of the defect included a high operative mortality. Instead, we chose to obtain a permanent drainage of the meningocele by putting a shunt between the meningocele and the peritoneum. Postoperatively, the patient recovered well and became oxygen-independent. CONCLUSION: Treatment of giant intrathoracic meningoceles in patients with progressive dyspnea can be challenging, and different options can be found in the literature. Treatment with a cystoperýtoneal shunt, as in our case, can be a less invasive alternative in patients with a high operative mortality risk. To our knowledge, this is the first report of a patient with neurofibromatosis 1 treated in this way. |
| Authors | Dimitri J Vanhauwaert, Marc J Deruytter
(Affiliation: Department of Neurosurgery, Heilig Hart Ziekenhuis, Roeselare, Belgium, 8800. vanhauwaertdimitri at telenet.be)
|
| Journal | Surgical neurology
(Surg Neurol)
Vol. 69
Issue 5
Pg. 535-7
(May 2008)
ISSN: 0090-3019 United States |
| PMID | 18262243
(Publication Type: Case Reports, Journal Article)
|
| Topics |
- Catheterization
- Drainage
(methods)
- Female
- Humans
- Meningocele
(complications, pathology, surgery)
- Middle Aged
- Neurofibromatoses
(complications, pathology, surgery)
- Peritoneum
- Thoracic Vertebrae
|
