Meningeal hernia: What you need to know

Herniation of the spinal cord is a rare disease, occurring due to birth defects in the spinal canal (the hollow space of the vertebrae, which contains the spinal cord and nerve roots) of the child. Meningeal hernia is a serious medical condition, causing loss or dysfunction of nerve function, affecting appearance, daily activities and potential health risks in patients.

Meningocele is a congenital defect in the posterior arch of the vertebrae and the medulla oblongata is exposed, but there is no abnormal nerve tissue. About one-third have neurological deficits.
Myelomeningocele is a congenital defect in the posterior arch of the vertebrae and the membranous membrane is exposed in the form of a cyst, accompanied by functional or structural abnormalities of the spinal cord or the cauda equina.
If not treated, over time, meningeal herniation will have dangerous developments, especially the meningeal hernia sac will grow very quickly because brain tissue and cerebrospinal fluid continue to herniate. down. This causes severe neurological and cosmetic defects in the affected child.

During the embryonic stage at 18 days, if a defect in the closure of the neural tube at the rostral neuropore at the head of the embryo is found, a malformation of the meninges and hernias of the meninges will form. When there is a defect in neural tube closure at the caudal neuropore of the embryonic tail, a spina bifida malformation can be opened or closed.

Clinical diagnosis:
The recognizable feature of meningeal hernia in children is the appearance of tumors in the lumbar - sacral region. This tumor is usually soft, covered with wrinkled skin, inside is cerebrospinal fluid or a mixture of brain tissue and cerebrospinal fluid. In terms of morphological characteristics, the herniated mass can have different shapes as follows: The skin is relatively thick, rarely breaks, causing cerebrospinal fluid leakage; the skin is thin, shiny, easy to tear, causing cerebrospinal fluid leakage; The skin and subcutaneous fat layer in the hernia sac is quite thick, palpating externally like a tumor. Some other features of the hernia sac are often described as concave when pressed but then rapidly swell. This hernia sac can change size according to the heart rate and breathing rate of the child. Meningeal hernias usually do not present with motor and sensory disturbances. However, the disease can cause partial or complete paralysis of the legs, loss of sensation and sphincter disturbances common in cases of hernia sacs with nerve roots and spinal cord. Subclinical diagnosis:
When X-ray of the spine is taken, the position and extent of the posterior arch defect will be seen. Magnetic resonance imaging (MRI) of the lumbar spine: MRI is currently the most valuable imaging diagnosis for the diagnosis of myelomeningocele - medullary hernia. In most cases, MRI can determine whether there is a hernia, what type of hernia is, what is the nature of the mass, the location of the neck of the hernia sac, the size of the hernia mass, the subcutaneous fatty tissue, and the stomach. The position of the spinal apex relative to the vertebral body, the low-attachment of the spinal cord, the evaluation of the entire nerve axis, the relationship between the herniated mass and the spinal cord, the assessment of associated malformations, helps to confirm the diagnosis and assessment. Full price before surgery as well as after surgery.

Meningeal hernia surgery is the optimal method to treat meningeal hernia. If detected early, meningeal hernia can be operated within the first 24 hours after birth.
However, surgery for children with meningeal hernia is extremely complicated. Children need to be prepared very carefully before surgery, assess the degree of nerve damage. After surgery, children need to be closely monitored for complications, especially infection.