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Anterior Sacral Meningocele
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Anterior sacral meningocele (ASM)
              • Definitions

                • Sacral meninges herniate anteriorly into pelvis through focal erosion or hypogenesis of sacral ± coccygeal vertebral segments

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nonvascular Interventions

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Hollenberg AM et al: Rupture of a giant anterior sacral meningocele in a patient with Marfan syndrome: diagnosis and management. World Neurosurg. ePub, 2018
                                                2. Chakhalian D et al: Multidisciplinary surgical treatment of presacral meningocele and teratoma in an adult with Currarino triad. Surg Neurol Int. 8:77, 2017
                                                3. Croci DM et al: Thalidomide embryopathy as possible cause of anterior sacral meningocele: a case report. Birth Defects Res. 109(17):1390-2, 2017
                                                4. Gupta S et al: Recurrent abortion and tethered cord syndrome caused by anterior sacral meningocele: a report of a rare case with a review of the literature. World Neurosurg. 101:815.e5-815.e7, 2017
                                                5. Balioğlu MB et al: Sacral agenesis: evaluation of accompanying pathologies in 38 cases, with analysis of long-term outcomes. Childs Nerv Syst. ePub, 2016
                                                6. Porsch RM et al: Sacral agenesis: a pilot whole exome sequencing and copy number study. BMC Med Genet. 17(1):98, 2016
                                                7. Shastin D et al: A rare case of anterior sacral meningocoele presenting as cauda equina syndrome. Br J Neurosurg. 29(3):428-9, 2015
                                                8. Duru S et al: Currarino syndrome: report of five consecutive patients. Childs Nerv Syst. 30(3):547-52, 2014
                                                9. Kemp J et al: Holocord syringomyelia secondary to tethered spinal cord associated with anterior sacral meningocele and tailgut cyst: case report and review of literature. Childs Nerv Syst. 30(6):1141-6, 2014
                                                10. Herion NJ et al: Traffic jam in the primitive streak: the role of defective mesoderm migration in birth defects. Birth Defects Res A Clin Mol Teratol. 100(8):608-22, 2014
                                                11. Aydoseli A et al: Anterior sacral meningocele in a patient with currarino syndrome as a cause of ileus. Br J Neurosurg. 27(6):833-5, 2013
                                                12. Beyazal M: An asymptomatic large anterior sacral meningocele in a patient with a history of gestation: a case report with radiological findings. Case Rep Radiol. 2013:842620, 2013
                                                13. Castelli E et al: Huge anterior sacral meningocele simulating bladder retention. Urology. 81(2):e9-10, 2013
                                                14. Polat AV et al: Anterior sacral meningocele mimicking ovarian cyst: a case report. Med Ultrason. 15(1):67-70, 2013
                                                15. Versteegh HP et al: "This bicycle gives me a headache", a congenital anomaly. BMC Res Notes. 6:412, 2013
                                                16. Isik N et al: The shrinking of an anterior sacral meningocele in time following transdural ligation of its neck in a case of the Currarino triad. Turk Neurosurg. 18(3):254-8, 2008
                                                17. Miletic D et al: Giant anterior sacral meningocele presenting as bacterial meningitis in a previously healthy adult. Orthopedics. 31(2):182, 2008
                                                18. Sánchez AA et al: Rectothecal fistula secondary to an anterior sacral meningocele. J Neurosurg Spine. 8(5):487-9, 2008
                                                19. Bayar AM et al: Anterior sacral meningocele. A case report. J Neurosurg Sci. 51(2):89-92, 2007
                                                20. Trapp C et al: Laparoscopic treatment of anterior sacral meningocele. Surg Neurol. 68(4):443-8; discussion 448, 2007
                                                21. Erdogmus B et al: Anterior sacral meningocele simulating ovarian cyst. J Clin Ultrasound. 34(5):244-6, 2006
                                                22. Gardner PA et al: "Like mother, like son:" hereditary anterior sacral meningocele. Case report and review of the literature. J Neurosurg. 104(2 Suppl):138-42, 2006
                                                23. Phillips JT et al: Anaerobic meningitis secondary to a rectothecal fistula arising from an anterior sacral meningocele: report of a case and review of the literature. Dis Colon Rectum. 49(10):1633-5, 2006
                                                24. Marin-Sanabria EA et al: Presacral meningocele associated with hereditary sacral agenesis and treated surgically: evaluation in three members of the same family. Neurosurgery. 57(3):E597; discussion E597, 2005
                                                25. Schijman E et al: Anterior sacral meningocele. Childs Nerv Syst. 21(2):91-3, 2005
                                                26. Rigante D et al: Anterior sacral meningocele in a patient with Marfan syndrome. Clin Neuropathol. 20(2):70-2, 2001
                                                27. Clatterbuck RE et al: Laparoscopic treatment of an anterior sacral meningocele. Case illustration. J Neurosurg. 92(2 Suppl):246, 2000
                                                28. Fitzpatrick MO et al: Anterior sacral meningocele associated with a rectal fistula. Case report and review of the literature. J Neurosurg. 91(1 Suppl):124-7, 1999
                                                29. Shamoto H et al: Anterior sacral meningocele completely occupied by an epidermoid tumor. Childs Nerv Syst. 15(4):209-11, 1999
                                                30. Voyvodic F et al: Anterior sacral meningocele as a pelvic complication of Marfan syndrome. Aust N Z J Obstet Gynaecol. 39(2):262-5, 1999
                                                31. Lee SC et al: Currarino triad: anorectal malformation, sacral bony abnormality, and presacral mass--a review of 11 cases. J Pediatr Surg. 32(1):58-61, 1997
                                                32. Gaskill SJ et al: The Currarino triad: its importance in pediatric neurosurgery. Pediatr Neurosurg. 25(3):143-6, 1996
                                                33. Funayama CA et al: Recurrent meningitis in a case of congenital anterior sacral meningocele and agenesis of sacral and coccygeal vertebrae. Arq Neuropsiquiatr. 53(4):799-801, 1995
                                                34. Raftopoulos C et al: Anterior sacral meningocele and Marfan syndrome: a review. Acta Chir Belg. 93(1):1-7, 1993
                                                35. Chamaa MT et al: Anterior-sacral meningocele; value of magnetic resonance imaging and abdominal sonography. A case report. Acta Neurochir (Wien). 109(3-4):154-7, 1991
                                                36. McGuire RA Jr et al: Anterior sacral meningocele. Case report and review of the literature. Spine. 15(6):612-4, 1990
                                                37. North RB et al: Occult, bilateral anterior sacral and intrasacral meningeal and perineurial cysts: case report and review of the literature. Neurosurgery. 27(6):981-6, 1990
                                                38. Lee KS et al: The role of MR imaging in the diagnosis and treatment of anterior sacral meningocele. Report of two cases. J Neurosurg. 69(4):628-31, 1988
                                                39. Martin B et al: MR imaging of anterior sacral meningocele. J Comput Assist Tomogr. 12(1):166-7, 1988
                                                40. Dyck P et al: Anterior sacral meningocele. Case report. J Neurosurg. 53(4):548-52, 1980
                                                41. Shermam RM et al: Anterior sacral meningocele. Am J Surg. 79(5):743-7, 1950
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Anterior sacral meningocele (ASM)
                                                            • Definitions

                                                              • Sacral meninges herniate anteriorly into pelvis through focal erosion or hypogenesis of sacral ± coccygeal vertebral segments

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Ultrasonographic Findings

                                                                      • Nonvascular Interventions

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Hollenberg AM et al: Rupture of a giant anterior sacral meningocele in a patient with Marfan syndrome: diagnosis and management. World Neurosurg. ePub, 2018
                                                                                              2. Chakhalian D et al: Multidisciplinary surgical treatment of presacral meningocele and teratoma in an adult with Currarino triad. Surg Neurol Int. 8:77, 2017
                                                                                              3. Croci DM et al: Thalidomide embryopathy as possible cause of anterior sacral meningocele: a case report. Birth Defects Res. 109(17):1390-2, 2017
                                                                                              4. Gupta S et al: Recurrent abortion and tethered cord syndrome caused by anterior sacral meningocele: a report of a rare case with a review of the literature. World Neurosurg. 101:815.e5-815.e7, 2017
                                                                                              5. Balioğlu MB et al: Sacral agenesis: evaluation of accompanying pathologies in 38 cases, with analysis of long-term outcomes. Childs Nerv Syst. ePub, 2016
                                                                                              6. Porsch RM et al: Sacral agenesis: a pilot whole exome sequencing and copy number study. BMC Med Genet. 17(1):98, 2016
                                                                                              7. Shastin D et al: A rare case of anterior sacral meningocoele presenting as cauda equina syndrome. Br J Neurosurg. 29(3):428-9, 2015
                                                                                              8. Duru S et al: Currarino syndrome: report of five consecutive patients. Childs Nerv Syst. 30(3):547-52, 2014
                                                                                              9. Kemp J et al: Holocord syringomyelia secondary to tethered spinal cord associated with anterior sacral meningocele and tailgut cyst: case report and review of literature. Childs Nerv Syst. 30(6):1141-6, 2014
                                                                                              10. Herion NJ et al: Traffic jam in the primitive streak: the role of defective mesoderm migration in birth defects. Birth Defects Res A Clin Mol Teratol. 100(8):608-22, 2014
                                                                                              11. Aydoseli A et al: Anterior sacral meningocele in a patient with currarino syndrome as a cause of ileus. Br J Neurosurg. 27(6):833-5, 2013
                                                                                              12. Beyazal M: An asymptomatic large anterior sacral meningocele in a patient with a history of gestation: a case report with radiological findings. Case Rep Radiol. 2013:842620, 2013
                                                                                              13. Castelli E et al: Huge anterior sacral meningocele simulating bladder retention. Urology. 81(2):e9-10, 2013
                                                                                              14. Polat AV et al: Anterior sacral meningocele mimicking ovarian cyst: a case report. Med Ultrason. 15(1):67-70, 2013
                                                                                              15. Versteegh HP et al: "This bicycle gives me a headache", a congenital anomaly. BMC Res Notes. 6:412, 2013
                                                                                              16. Isik N et al: The shrinking of an anterior sacral meningocele in time following transdural ligation of its neck in a case of the Currarino triad. Turk Neurosurg. 18(3):254-8, 2008
                                                                                              17. Miletic D et al: Giant anterior sacral meningocele presenting as bacterial meningitis in a previously healthy adult. Orthopedics. 31(2):182, 2008
                                                                                              18. Sánchez AA et al: Rectothecal fistula secondary to an anterior sacral meningocele. J Neurosurg Spine. 8(5):487-9, 2008
                                                                                              19. Bayar AM et al: Anterior sacral meningocele. A case report. J Neurosurg Sci. 51(2):89-92, 2007
                                                                                              20. Trapp C et al: Laparoscopic treatment of anterior sacral meningocele. Surg Neurol. 68(4):443-8; discussion 448, 2007
                                                                                              21. Erdogmus B et al: Anterior sacral meningocele simulating ovarian cyst. J Clin Ultrasound. 34(5):244-6, 2006
                                                                                              22. Gardner PA et al: "Like mother, like son:" hereditary anterior sacral meningocele. Case report and review of the literature. J Neurosurg. 104(2 Suppl):138-42, 2006
                                                                                              23. Phillips JT et al: Anaerobic meningitis secondary to a rectothecal fistula arising from an anterior sacral meningocele: report of a case and review of the literature. Dis Colon Rectum. 49(10):1633-5, 2006
                                                                                              24. Marin-Sanabria EA et al: Presacral meningocele associated with hereditary sacral agenesis and treated surgically: evaluation in three members of the same family. Neurosurgery. 57(3):E597; discussion E597, 2005
                                                                                              25. Schijman E et al: Anterior sacral meningocele. Childs Nerv Syst. 21(2):91-3, 2005
                                                                                              26. Rigante D et al: Anterior sacral meningocele in a patient with Marfan syndrome. Clin Neuropathol. 20(2):70-2, 2001
                                                                                              27. Clatterbuck RE et al: Laparoscopic treatment of an anterior sacral meningocele. Case illustration. J Neurosurg. 92(2 Suppl):246, 2000
                                                                                              28. Fitzpatrick MO et al: Anterior sacral meningocele associated with a rectal fistula. Case report and review of the literature. J Neurosurg. 91(1 Suppl):124-7, 1999
                                                                                              29. Shamoto H et al: Anterior sacral meningocele completely occupied by an epidermoid tumor. Childs Nerv Syst. 15(4):209-11, 1999
                                                                                              30. Voyvodic F et al: Anterior sacral meningocele as a pelvic complication of Marfan syndrome. Aust N Z J Obstet Gynaecol. 39(2):262-5, 1999
                                                                                              31. Lee SC et al: Currarino triad: anorectal malformation, sacral bony abnormality, and presacral mass--a review of 11 cases. J Pediatr Surg. 32(1):58-61, 1997
                                                                                              32. Gaskill SJ et al: The Currarino triad: its importance in pediatric neurosurgery. Pediatr Neurosurg. 25(3):143-6, 1996
                                                                                              33. Funayama CA et al: Recurrent meningitis in a case of congenital anterior sacral meningocele and agenesis of sacral and coccygeal vertebrae. Arq Neuropsiquiatr. 53(4):799-801, 1995
                                                                                              34. Raftopoulos C et al: Anterior sacral meningocele and Marfan syndrome: a review. Acta Chir Belg. 93(1):1-7, 1993
                                                                                              35. Chamaa MT et al: Anterior-sacral meningocele; value of magnetic resonance imaging and abdominal sonography. A case report. Acta Neurochir (Wien). 109(3-4):154-7, 1991
                                                                                              36. McGuire RA Jr et al: Anterior sacral meningocele. Case report and review of the literature. Spine. 15(6):612-4, 1990
                                                                                              37. North RB et al: Occult, bilateral anterior sacral and intrasacral meningeal and perineurial cysts: case report and review of the literature. Neurosurgery. 27(6):981-6, 1990
                                                                                              38. Lee KS et al: The role of MR imaging in the diagnosis and treatment of anterior sacral meningocele. Report of two cases. J Neurosurg. 69(4):628-31, 1988
                                                                                              39. Martin B et al: MR imaging of anterior sacral meningocele. J Comput Assist Tomogr. 12(1):166-7, 1988
                                                                                              40. Dyck P et al: Anterior sacral meningocele. Case report. J Neurosurg. 53(4):548-52, 1980
                                                                                              41. Shermam RM et al: Anterior sacral meningocele. Am J Surg. 79(5):743-7, 1950