Anterior sacral meningocele presenting as intracystic bleeding

  • Ignacio Javier Gilete-Tejero
  • Marta Ortega-Martínez
  • Jacinto Mata-Gómez
  • María Rico-Cotelo
  • Luis Miguel Bernal-García
  • Beatriz Yerga-Lorenzana
  • Ignacio Casado-Naranjo
Case Report

DOI: 10.1007/s00586-017-5128-1

Cite this article as:
Gilete-Tejero, I.J., Ortega-Martínez, M., Mata-Gómez, J. et al. Eur Spine J (2017). doi:10.1007/s00586-017-5128-1

Abstract

Purpose

To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions.

Methods

A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum. Likewise, the MRI showed an image compatible with subarachnoid hemorrhage in the thoracic spinal area, cerebral convexity, and the basal cisterns. The patient went into surgery for an anterior abdominal approach in the midline to reduce the content of the lesion, and subsequently, in the same act, a posterior approach was done with an S1–S2 laminectomy and obliteration of the pedicle. Postoperative MRI 5 months later showed resolution of the ASM.

Results

Anterior sacral meningocele is characterized by herniation of the dura mater and the arachnoid mater outside the spinal canal through a defect of the sacrum. We add the risk of bleeding after trauma—never seen in the literature—as one of the possible inherent complications of this lesion.

Conclusions

This report highlights a complication never seen in the literature of a relatively rare condition. In our case, the combined approach was effective for both clinical control and lesion regression.

Keywords

Anterior sacral meningocele Marfan syndrome Trauma Hemorrhage Surgery 

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Ignacio Javier Gilete-Tejero
    • 1
  • Marta Ortega-Martínez
    • 1
  • Jacinto Mata-Gómez
    • 1
  • María Rico-Cotelo
    • 1
  • Luis Miguel Bernal-García
    • 2
  • Beatriz Yerga-Lorenzana
    • 3
  • Ignacio Casado-Naranjo
    • 3
  1. 1.Department of NeurosurgeryUniversity Hospital ComplexCáceresSpain
  2. 2.Department of NeurosurgeryUniversity Hospital ComplexBadajozSpain
  3. 3.Department of NeurologyUniversity Hospital ComplexCáceresSpain

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