myelomeningocele

Newborn with
a myelomeningocele. Sagittal T1 MRI without contrast of the brain (left) shows a small posterior fossa with downward cerebellar tonsil herniation and a small fourth ventricle. There is kinking of the spinal cord at the cervico-medullary junction. Sagittal (above right) and axial (below right) T2 MRI without contrast of the spine shows a low-lying conus medullaris with the spinal cord nerve roots terminating in a posteriorly located cerebrospinal fluid filled sac which is not covered by skin at the level of the L5-S1 vertebral bodies.The diagnosis was Chiari II malformation with a myelomeningocele.
pediatricimaging.org • CC-by-nc-sa 4.0
Preschooler
who had their myelomeningocele extending from L4-S5 repaired in utero. 3D reconstruction of CT without contrast of the lumbar spine shows lack of fusion of the posterior elements of the L4-S5 vertebral bodies.The diagnosis was myelomeningocele.
pediatricimaging.org • CC-by-nc-sa 4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Myelomeningocele, also known as spina bifida cystica, is a complex congenital spinal anomaly that results in spinal cord malformation (myelodysplasia).

Epidemiology

It is one of the commonest congenital CNS anomalies and thought to occur in approximately 1:500 of live births . There may be a slight female predilection.

Clinical presentation

Patients present with lower limb paralysis and sensory loss, bladder and bowel dysfunction as well as cognitive impairment.

Pathology

Results from failure of fusion of neural tube dorsally during embryogenesis.

There is a localized defect of the closure of caudal neuropore with persistence of neural placode (open spinal cord).

Location
  • lumbosacral: ~45%
  • thoracolumbar: ~30% 
  • lumbar: ~20%
  • cervical: ~2% 
Risk factors
Markers
Associations

Radiographic features

Antenatal ultrasound
  • may show evidence of an open neural tube defect with splayed or divergent posterior elements
Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Myelomeningozele:
Arachnoidalzyste
 
Wikipedia • CC BY-SA 3.0
Spina bifida
 
Wikipedia • CC BY-SA 4.0
Hydrocephalus
 
Wikipedia • CC BY-SA 4.0
Arnold-Chiari-Malformation
Typ 2
pediatricimaging.org • CC-by-nc-sa 4.0
Syringomyelie
 
Wikipedia • Public domain
Meningozele
 
www.eurorad.org • CC by-nc-sa-4.0
Myelozystozele
 
www.eurorad.org • CC by-nc-sa-4.0