Thoracic Meningocele and Cervical Syringomyelia Treated with Ventriculoperitoneal Shunt.

Background: Spinal meningocele is the herniation of dura mater and cerebrospinal fluid through a spinal defect, be it congenital, iatrogenic, or traumatic. Intrathoracic meningoceles are rare and are most commonly associated with neurofibromatosis. When indicated, surgical management of symptomatic thoracic meningocele is aimed at decreasing the size of the meningocele, which can be accomplished by a variety of procedures.

Case Description: A 59-year-old woman with neurofibromatosis type 1 and a known thoracic meningocele was initially managed conservatively. However, she developed syringomyelia and subsequently became symptomatic from the syrinx. She was ultimately treated successfully with ventriculoperitoneal shunt. Shunting resulted in complete resolution of the syrinx, while the thoracic meningocele remained stable in size.

Conclusions: Ventriculoperitoneal shunt can be used to successfully treat a symptomatic syrinx in a patient with an asymptomatic thoracic meningocele. Alterations in normal cerebrospinal fluid flow dynamics from the thoracic meningocele likely contributed to the development of syringomyelia in this patient.