title: A neurofibromatosis type 1 patient with thoracic encapsulated fluid and intracranial hypotension syndrome: a case report.
abstract: BACKGROUND
  Spinal meningoceles are uncommon entities, mostly associated with neurofibromatosis type 1 (NF-1). Their intrusion into the thoracic cavity, which compresses lung tissue, is quite often mistaken as a "pleural effusion." The withdrawal of a large amount of "pleural effusion" can lead to the intracranial hypotension syndrome (IHS), herniation, or even death.
  
  
  METHODS
  A 43-year-old woman, with NF-1 and a large "pleural effusion" which compressed lung tissue, was admitted to the Thoracic Department due to the patient's shortness of breath during her physical activities. The patient complained of headache shortly after withdrawal of about 250 mL of "pleural effusion." She was diagnosed with IHS according to the typical symptoms of postural headache, low cerebrospinal fluid (CSF) pressure and magnetic resonance imaging findings of diffuse pachymeningeal gadolinium enhancement. The "pleural effusion" was examined and found to be CSF.
  
  
  CONCLUSIONS
  The reported case is the first 1 in the literature in which the intrusion of the NF-1 patient's spinal meningoceles into the thoracic cavity was diagnosed as a "pleural effusion" and large CSF withdrawal led to IHS. We highlight the possibility that thoracic meningoceles can coexist with a thoracic spinal deformity and the caution that needs to be taken when cases with similar symptoms are subjected to withdrawal of fluid.
authors.affiliation: Department of Neurology, The Affiliated Union Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors.forename: Tian-Wen
authors.initials: TW
authors.lastname: Huang
authors.forename: Hua-Pin
authors.initials: HP
authors.lastname: Huang
authors.forename: Qin-Yong
authors.initials: QY
authors.lastname: Ye
authors.forename: Chun-Hui
authors.initials: CH
authors.lastname: Che
authors.forename: An
authors.initials: A
authors.lastname: Zheng
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Wen-Ting
authors.initials: WT
authors.lastname: Xiong
authors.forename: Xiao-Chun
authors.initials: XC
authors.lastname: Chen
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008588:Meningocele / Q000150:complications* / Q000209:etiology*; D009456:Neurofibromatosis 1 / Q000150:complications*; D010996:Pleural Effusion; D013904:Thoracic Vertebrae