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HomeHealth articlesmeningoceleWhat Is a Meningocele?

Meningocele - Causes, Signs and Symptoms, Complications, Types, Diagnosis and Treatment

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Meningocele is a congenital defect where there is an abnormal dilation of the meninges and is filled with cerebrospinal fluid. Read to know more.

Medically reviewed by

Dr. Anuj Gupta

Published At September 27, 2022
Reviewed AtJanuary 19, 2024

Introduction:

Most babies are born perfect as new human beings after staying in their mother's womb for almost nine to ten months. However, in rare cases, some babies undergo defects in their growth while still in the womb. Such babies are known to be born with congenital defects. Meningocele is one of those common congenital defects where a baby undergoes abnormal formation of the spinal cord. This results in an abnormal dilation or enlargement of the meninges, which are filled with cerebrospinal fluid (CSF). There are no nerves in the meningocele. This abnormal enlargement communicates with the subcutaneous tissue because there is a defect in the bones, which normally cover the spinal cord and meninges. A thin layer of skin covers this sac.

What Is a Meningocele?

Meningocele is a common congenital defect seen in the baby’s back or neck. It is a type of spina bifida. Here, in this condition, the baby has an abnormally formed spine with a gap in between the vertebral bones. This results in developing a sac of cerebrospinal fluid (spinal fluid) covered by a thin layer of skin that may or may not be seen outside the body. This sac of cerebrospinal fluid called a meningocele, is seen in the lower back or neck.

Meningomyelocele is an open spina bifida, which is a devastating congenital malformation of the CNS (central nervous system). This condition is associated with severe morbidity and mortality.

What Is the Life Expectancy of Spina Bifida?

Most of the children who are born with this condition will survive their three decades of life.

What Is the Difference Between Meningocele vs Myelomeningocele?

  • Meningocele: This condition is a defect in the posterior region of the spine along with extrusion of CNS (cerebrospinal fluid) and meninges. The neural element does not get involved.

  • Myelomeningocele: In this condition, there will be an extrusion of CNS, meninges, as well as neural elements.

What Causes Meningocele?

The accurate cause of meningocele is yet to be known. Some baby-bearing mothers are at a higher risk of giving birth to a baby with spina bifida. Some of the common risk factors are If a mother lacks folic acid during pregnancy. Past history of having a baby with meningocele. Antiepileptic drugs like Phenytoin or Valproate intake during pregnancy. Meningocele is known to occur during the first trimester of pregnancy. At first, the fetus’s spinal cord is flat, which later forms into a tube, a neural tube. When this tube does not fuse properly, then the baby is known to be born with meningocele.

What Are the Common Signs and Symptoms Associated With Meningocele?

Usually, meningocele is not visible over the skin, but there could be some tell-tale signs like abnormal hair patches at the back or soft tissue swelling of fat, known as lipoma. Most babies born with meningocele might not experience any symptoms. However, in some babies, when meningocele causes damage to the surrounding nerve tissues, specific issues related to the nerves can develop.

Some of them are as follows:

  • Some issues with movements.

  • The baby might find it difficult to control their pee and poop.

  • Aesthetic issues with a protruding sac of spinal fluid outside the body.

  • Gastrointestinal problems, bowel obstruction, leaking stools, and constipation are common.

  • Neurological issues like paralysis of the lower body or physical deformity can occur.

  • Overactive muscle reflexes.

  • Muscle stiffness.

  • Muscle weakness.

  • Recurrent urinary tract infections.

  • Inability to control urine and bedwetting.

What Are the Complications Associated With Meningocele?

Meningoceles do not usually cause any life-threatening complications and are known to have an excellent prognosis if detected early and followed properly. However, in some cases with untreated meningoceles, the infants may develop some of the following complications:

  1. Meningoceles can increase intracranial pressure.

  2. The cerebrospinal fluid leak can occur due to the erosion of the base of the skull.

  3. Hydrocephalus is often seen as associated with myelomeningocele.

  4. Tethered cord syndrome (a condition characterized by symptoms related to increased tension in the spinal cord).

Are There More Types of Spina Bifida?

Spina bifida can be classified into the following types namely:

  1. Myelomeningocele: This condition is characterized by a protruding sac that pushes through the gap in the spine. The sac contains spinal fluid and meninges and is seen outside the body of the infant, usually in the lower back.

  2. Spina Bifida Occulta: In this case, there is a gap between the spinal bones, but a sac of spinal fluid does not usually push out of the baby’s body.

How to Diagnose Meningoceles?

Meningocele can be diagnosed before the birth of a child by the following diagnostic methods:

  • Regular monthly ultrasound scans.

  • Amniocentesis (a procedure where the amniotic fluid that surrounds and protects a baby inside the womb is tested).

  • Alpha-fetoprotein (AFP) can be tested during the second trimester.

  • Multiple marking screening tests can be done.

  • The meningocele can be visible in ultrasound, while amniocentesis can denote a neural tube defect.

What Are the Treatment Measures for Meningocele?

Meningocele shows an amazing prognosis after treatment. Appropriate treatments can avoid complications, and the babies are known to live a normal and healthy life thereafter. Mostly, surgery is performed within a few days after birth, where the spinal contents are put back into the spinal cord, and the opening is closed surgically to avoid infections.

Endoscopic Endonasal Approach (EEA): This surgery method is a minimally invasive surgical approach where a surgeon approaches the meningoceles present in the upper back or at the base of the skull via a nasal corridor. This prevents making an evident incision, which in turn prevents scarring. Then, the doctor removes the meningocele without causing any damage to the surrounding vital structures. EEA provides fast recovery and has very few complications.

How Can Parents Help During Meningocele?

Most affected babies do well, and they require regular check-ups with doctors to ensure that they are developing normally.

Conclusion:

Recent advances in medicine have developed several advanced methods to treat spina bifida, enhancing the quality of life of infants born with this congenital defect. A regular monthly ultrasound checkup during pregnancy can help the doctor plan appropriate treatments before birth. Also, after the surgical treatment, the parents are asked to bring the baby in regular intervals for a follow-up to assess and prevent further complications associated with meningocele.

Frequently Asked Questions

1.

What Are Meningocele and Myelomeningocele?

Meningoceles, a type of spina bifida, a neural tube abnormality, is a congenital abnormality that results in the meninges (protective layers of the brain and spinal cord) and cerebrospinal fluid protruding from the posterior parts of the spine without affecting the neural elements. The most severe form of spina bifida, myelomeningocele, involves the ejection of meninges, cerebrospinal fluid, and functioning neural parts, including nerve or spinal cord contents.

2.

What Are the Effects of Meningocele in Babies?

The majority of infants with meningocele do not exhibit any symptoms. The nerves around the spine can sometimes sustain damage. However, it only happens sometimes. In addition to various medical concerns, such as difficulty moving or controlling when one urinates and defecates, this can also cause esthetic problems due to an externally projecting spinal fluid sac. Muscle stiffness and weakness, physical deformities including lower body paralysis, and neurological problems, hydrocephalus (the buildup of fluid and pressure in the brain), increased likelihood of gastrointestinal issues, urinary tract infections, spinal cord inflammation or infection, loss of nerve function can cause paralysis, weakness, or alterations in sensation are some of the other effects of meningocele.

3.

Is Meningocele a Serious Condition?

The simplest type of open neural tube defect, meningocele, is characterized by a cystic enlargement of the meninges, which contain cerebrospinal fluid but no neural tissue. With straightforward surgical repair of the meninges, patients with meningocele have an excellent prognosis. It is not a severe condition like other types of spinal bifida.

4.

What Distinguishes Meningocele From Spina Bifida?

When the baby's spine (backbone) does not develop normally during pregnancy, spina bifida occurs, leading to a gap in the bones. Meningocele is a form of spina bifida in which meninges and cerebrospinal fluid extrude through the opening without involving neural components.

5.

What Are the 4 Different Types of Spina Bifida?

Occulta, closed neural tube defects, meningocele, and myelomeningocele are the four different kinds of spina bifida. The type of spina bifida that is most prevalent and least likely to result in symptoms that call for medical attention is spina bifida occulta.

6.

Can Meningocele Be Cured?

Early in pregnancy, meningocele, a form of neural tube abnormality, develops when a fluid-filled sac protrudes from a gap in the back of the fetus. Meningocele can be repaired surgically during pregnancy or after birth. After a meningocele surgery, kids frequently recover well and do not experience any new issues with their muscles, nerves, or brains. Although the condition has a remarkable prognosis when treated, side effects may reduce the quality of life.

7.

What Are the Meningocele Risk Factors?

Low pregnancy folic acid intake, having spina bifida in one's family, and having certain medications, such as seizure medication and valproic acid, are reported to be associated with an increased risk of meningocele in the unborn child.

8.

Where Is Meningocele Located?

Meningoceles are frequently found in the vertebral arches of the lumbosacral area. The bone anomaly in these lesions seldom affects more than two to three vertebrae and is frequently covered by skin. Cerebrospinal fluid can be found inside the meningocele sac, which comprises both arachnoid and dural meninges.

9.

Is Meningocele Open or Closed Neural Tube Defect?

A sac that pushes through the opening in the spine is called a meningocele. Typically, a thin layer of skin covers it. A type of open neural tube defect, meningocele, is characterized by a cystic enlargement of the meninges, which contain cerebrospinal fluid but no neural tissue. With straightforward surgical repair of the meninges, patients with meningocele have an excellent prognosis.

10.

Is Meningocele Hereditary?

Meningocele can develop in people who have no family history of the condition. A tiny percentage of cases have been noted to run in families. However, there is no obvious inheritance pattern for the ailment.

11.

Can a Meningocele Rupture, and What Will Be the Effect?

Yes, a ruptured meningocele increases the risk of meningitis and other complications and has the potential to be fatal.

12.

How Long Can Children Live With Spina Bifida Meningocele?

Spina bifida patients with fewer disorders and no other severe medical conditions might anticipate an average lifespan. The life expectancy may be shortened in people with more severe forms of spina bifida or those with other related health issues (such as hydrocephalus). When given the proper care and treatment, many children with spina bifida survive into adulthood. The average age of a person with spina bifida is 40 years, according to estimates.

13.

How Can Spina Bifida Meningocele Be Diagnosed?

The most reliable way to identify spina bifida in an unborn child before delivery is through fetal ultrasonography. The first trimester (11 to 14 weeks) and the second (18 to 22 weeks) are suitable for ultrasound procedures. The ultrasound scan performed in the second trimester can be used to detect spina bifida precisely. A prenatal blood test for alpha-fetoprotein (AFP) can also determine whether a baby is at risk for developing a meningocele.

14.

Folic Acid: Does It Prevent Spina Bifida?

Prenatal folic acid supplementation has been shown to reduce the risk of neural tube abnormalities such as spina bifida in up to seven out of ten pregnancies. In actuality, meningocele risk factors include folic acid deficiency.

15.

Which Gender Is More Likely to Have Spina Bifida?

White and Hispanic persons are more likely to have spina bifida, and girls are affected more frequently than males.
Dr. Anuj Gupta
Dr. Anuj Gupta

Spine Surgery

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