2009-11-18-09 Meningocele with filiform connection © Cuillier www.thefetus.net/
Meningocele with filiform connection
Fabrice Cuillier, MD.
Service de Gynécologie, Hôpital F. Guyon, 97400 Saint-Denis, Réunion, France.
The following images represent a case of meningocele with filiform connection. A 30-year-old woman G4P3 with non contributive medical history was admitted to the hospital at 27 weeks for the risk of premature labor. She had no previous ultrasound or biochemistry screening done during her ongoing pregnancy.
While performing the ultrasound on the admission, we revealed a round mass located at he occipital part of the cranium. This isolated finding was suggestive of a occipital meningocele with a filiform connection. There were no cerebral anomalies on the ultrasound examination. The fetal MRI was performed at 29 weeks of gestation and confirmed the primary diagnosis.
Patient delivered spontaneously at the 30 weeks of gestation due to a premature labor. Postnatal examination of the baby confirmed our prenatal ultrasound diagnosis of meningocele. There was no deficit on the neurological examination. The skin on the spine was intact. The surgery will be performed at the 6 months age of the neonate.
Images 1,2: Image 1 shows a profile of the fetus at 27 weeks, nasal bone of normal length. Image 2 shows an axial view of the brain, note mild ventriculomegaly.
Images 3,4: Image 3 shows the meningocele located in the occipital region, indicated by the arrow. Image 4 shows a detail of the meningocele.
Images 5,6: Image 5 shows a crosssection of the meningocele. Image 6 shows the filiform connection among the spine and the meningocele.
Images 7,8: Image 7 shows a narrow connection among the meningocele and the spine indicated by arrow. Image 8 shows the transverse view of the meningocele (arrow) with nicely visible connection with the spine.
Images 9,10: 3D images of the meningocele.
Images 11,12: The images show the vascularization of the fetal brain.
Image 13: Image shows the thoracic and lumbar spine with no apparent abnormalities.
Images 14, 15: MRI images, meningocele on the image 14 is indicated by the arrow.
Image 16: The neonate after delivery at 30 weeks with apparent meningocele.