Meningocele

This condition causes the protective layer around the baby’s spinal cord to push through an opening in their spine. This condition is called meningocele (a type of spina bifida), and it is often treated shortly after birth. Most of the time, children recover well with few chronic (long-term) health problems.

Meningocele often occurs when the lower end of the neural tube does not develop properly during fetal development. Furthermore, the lower back is the most common spot for a bulge or sac to form. This sac is filled with a fluid called cerebrospinal fluid (CSF) that normally cushions and protects the baby’s brain and spinal cord. In addition, meningocele is the rarest form of spinal bifida.

Types of Meningocele

Physicians have categorized this condition into 2 types. For example:

Open – When it occurs, there is no skin covering the sac that sticks out of the opening in the child’s spine.
Closed – In such cases, the sac that sticks out of the spine is covered with skin.

Symptoms

While the most common symptom of meningocele is a fluid-filled lump on the baby’s back, this condition may also cause other symptoms. Check some of them below:

Back pain
Muscle weakness
Fluttering heartbeat
Difficulty swallowing (dysphagia)
Dyspnea (shortness of breath)
Cough
Changes to the sound of their cry

If you notice your baby experiences any of the previous symptoms, immediately contact your healthcare professional. Otherwise, it may lead to serious complications.

Causes and Risk Factors

This condition is a neural type defect that occurs during fetal development. In general, the neural tube is an embryonic structure that develops into the brain and spinal cord. In babies with meningocele, this tube develops properly, but the bones of the spine do not close completely, which makes a gap in the spinal column. Therefore, the protective membranes that cover the spinal cord (meninges) push out through this gap. The lump (sac) that sticks out of the spine contains cerebrospinal fluid (CSF).

Healthcare professionals have identified some factors that may increase your baby’s risk of meningocele. Check some examples below:

Gestational diabetes (this type of diabetes occurs in pregnant women)
Folate (folic acid) deficiency
Obesity (excessive body weight) or hyperthermia (increased body temperature) in pregnant women
Certain medicines – These include anti-seizure medicines (particularly Valproic acid and Carbamazepine)
Genetic factors – If you have a family history of neural tube defects (NTDs), the risk of your baby developing a meningocele significantly increases.
Environmental factors – Prolonged exposure to pesticides, toxins, or radiation during pregnancy also increases the risk.
Sociodemographic factors

Complications

Babies who develop a meningocele may also experience some complications, especially if the condition is left untreated. Check some of them below:

Meningitis – Without treatment, the protective sac that covers the spinal cord may break, which significantly increases the risk of a serious infection called meningitis (infection of the brain and spinal cord lining).
Tethered spinal cord – This complication causes the spinal cord to attach to the spinal column, causing it to stretch as the child grows. It may also cause progressive nerve damage, pain, loss of motor function, and other symptoms.
Bladder and bowel dysfunction – Nerve damage may lead to poor bladder and bowel control. In rare cases, it may lead to kidney damage.
Neurological and motor weakness – This is a less severe complication that may cause sensory loss or weakness in the lower limbs.
Hydrocephalus – This is a serious condition in which the fluid begins to accumulate in the brain.
Orthopedic problems – These include muscle imbalance, hip problems, or club feet.
Latex allergy – Usually, children with spina bifida are more prone to a severe allergy to latex products.
Paralysis
Increased intracranial pressure
Infections

The previous list does not contain a complete list of meningocele complications. In any case, you can consult your healthcare professional about measures to prevent them.

How to Prevent Meningocele?

Usually, a meningocele can be prevented by ensuring adequate folic acid intake (400-800 mcg daily) before and during pregnancy to support the proper development of the neural tube. You should also manage chronic health conditions (such as high cholesterol, diabetes, and others), avoid hot tubs or saunas, and maintain a healthy weight.

Diagnosis

Sometimes, doctors may suspect or see symptoms of this condition during routine prenatal blood and urine tests. However, the condition is diagnosed after delivery. Physicians may also perform additional tests to confirm the diagnosis. For example, MRI (magnetic resonance imaging) scans, ultrasounds, or CT (computed tomography) scans. In rare cases, doctors may recommend a C-section (cesarean birth) if they detect this condition during pregnancy. It often helps prevent damage to the sac around the spinal cord during delivery.

Treatment

The primary treatment for children with meningocele is surgery to remove the fluid-filled sac. Most of the time, surgery is enough to cure a meningocele. During this treatment, doctors perform the following things. For example:

General anesthesia
Make a cut (incision) into the sac on your baby’s spine
Drain the sac that pushed through the spine
Place the meninges on the baby’s exposed spinal cord
Close the incision

After surgery, the baby may stay in a hospital for 1-2 weeks for monitoring. Commonly, surgery to treat this condition is performed within 24 to 48 hours in children with open meningocele and within 72 hours if your child has a closed meningocele.

Furthermore, surgery may cause some adverse reactions. These include bleeding, infections, reactions to anesthesia, and others.

Frequently Asked Questions

When should my child see their healthcare provider?

It is recommended to see a doctor after surgery to ensure your child heals as expected. You may also need to visit pediatricians with your child to monitor their wellness and growth.

What is the difference between a meningocele and a myelomeningocele?

While both conditions are types of spina bifida, there are some differences between them. For instance, a meningocele causes a fluid-filled sac to protrude from the spine, but the spinal cord remains inside undamaged (in most cases). However, myelomeningocele is a more severe form in which the sac contains both the spinal cord and nerves, which may lead to severe nerve damage, paralysis, and usually requires lifelong care.

What disabilities can a meningocele cause?

In most cases, this condition does not cause complications, especially if babies get treatment as soon as possible. However, some of them may experience progressive difficulty controlling the flow of urine, damage to the nerves, and other complications. If you have any other questions, ask your healthcare provider.