Meningocele manque

Description

A 53-year-old man presented with right-sided sciatic-like pain. He was otherwise asymptomatic with no weakness, sphincter disturbances or gait problems. On examination, upper motor neuron signs were elicited in both lower limbs and an MRI of the whole spine was requested.

MRI showed dorsal tethering of the spinal cord secondary to a fibrous band, associated with two midline lipomas (figure 1). The affected cord segment was triangular in cross section (figure 2), and a syrinx was also observed at the affected level. Radiological appearances were compatible with meningocele manqué (MM).

Figure 1

Sagittal T2-weighted (A) and T1-weighted (B) MRI of the cervical spine shows a thin band of tissue tethering the dorsal cord to the dura at T1–2 level (arrow) with resultant formation of a syrinx. At T2–3 level, there is a focal lesion at the dorsal aspect of the thoracic cord...

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