case_images: PMC8492421_01
case_images: (a) Head computed tomography (CT) shows pneumocephalus in the posterior fossa (*). (b) T2-weighted sacral sagittal magnetic resonance imaging (MRI) revealed an anterior sacral meningocele (ASM) (#). (c) Contrast T1-weighted sacral sagittal MRI revealed an ASM whose caudal pole (#) was in contact with the recurrent pilonidal cyst (PC) (*). (d) Clear liquid (#) draining from the PC (*), increasing with Valsalva maneuver. (e) Sacral sagittal CT showed spina bifida (*) and the agenesis of a portion of the anterior sacrum (#).
case_images: SNI-12-463-g001.jpg
case_images: PMC8492421_01_SNI-12-463-g001.jpg
case_images: F1
case_images: The head computed tomography (CT) obtained in ED showed pneumocephalus in the posterior fossa [Figure 1a]. A spine magnetic resonance imaging (MRI) revealed an ASM [Figure 1b] whose caudal pole was in contact with the recurrent PC [Figure 1c]. Close inspection of the PC showed clear liquid draining spontaneously, increasing with Valsalva maneuver [Figure 1d]. Sacral CT showed spina bifida and the agenesis of a portion of the anterior sacrum [Figure 1e].
case_images: Intraoperative view showing (a) the first dural flap (*) suture over the spinal canal dura and (b) the second flap (*) sutured in a watertight fashion over the first flap. (c) Follow-up T2-weighted sagittal sacral magnetic resonance imaging confirmed the total closure of the anterior sacral meningocele (*).
case_images: SNI-12-463-g002.jpg
case_images: PMC8492421_01_SNI-12-463-g002.jpg
case_images: F2
case_images: The dural flap was sutured in watertight fashion to the spinal canal dura [Figure 2a]. A second flap was harvested from the meningocele, based in the cranial aspect of the anterior sacral defect and sutured in a watertight fashion over the first flap [Figure 2b]. The follow-up spine MRI confirmed the total closure of the ASM [Figure 2c].