THE OCCULT INTRASACRAL MENINGOCELE

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Abstract
A rare case of occult intrasacral meningocele is presented, the literature reviewed, symptoms and findings tallied, and possible etiologies explored. This congenital defect is a dilated sac, composed of the meninges lying wholly in an enlarged, thin-walled sacral canal and connected with the subarachnoid cul-de-sac above by a narrow cerebrospinal fluid channel. Symptoms referable to the low back, lumbosacral spinal nerves and urinary tract may mimic those of intervertebral disk syndrome, spinal canal neoplasms, inflammatory lesions and degenerative neurologic disease. Clues to underlying congenital defects within the spinal canal are skin changes (e.g., pilonidal sinus), soft tissue abnormalities (e.g., subcutaneous lipoma), and bone defects (e.g., spina bifida occulta). Possible etiologies range from a simple developmental arrest to theories involving cerebrospinal fluid pressure effects on the formation of the spinal cord and meninges.

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