title: Congenital meningocoele presenting in an adult.
abstract: A 53-year-old male patient presented with low back pain radiating to both lower limbs for 2 years and urinary incontinence for 2 months. He had swelled over his lower back since birth. The neurological examination revealed a decreased perianal sensation. Local examination of the lumbar swelling showed a brilliantly transilluminant, cystic midline swelling in the lumbar area with underlying spina bifida. Magnetic resonance imaging revealed a low-lying conus at L3 level associated with spina bifida at L5 and a meningocoele sac. The patient underwent excision of the meningocoele and detethering of cord by extirpation of hypertrophied filum terminale. The patient had an immediate relief of his symptoms. At 3 month follow-up the lumbar wound had healed well, and there was a significant improvement in the perianal hypoesthesia. The adult presentation of a congenital meningocoele and spinal dysraphism is rare, especially in the fifth decade. The possible causes of this delayed presentation are analyzed, and the relevant literature on the subject is presented.
authors.affiliation: Department of Neurosurgery, King Edward Memorial Hospital, Seth G.S. Medical College, Parel, Mumbai, Maharashtra, India.
authors.forename: Raghvendra V
authors.initials: RV
authors.lastname: Ramdasi
authors.affiliation: Department of Neurosurgery, King Edward Memorial Hospital, Seth G.S. Medical College, Parel, Mumbai, Maharashtra, India.
authors.forename: Trimurti D
authors.initials: TD
authors.lastname: Nadkarni
authors.affiliation: Department of Neurosurgery, King Edward Memorial Hospital, Seth G.S. Medical College, Parel, Mumbai, Maharashtra, India.
authors.forename: Atul H
authors.initials: AH
authors.lastname: Goel
keywords: Adult meningocoele; spinal dysraphism; tethered cord