caa a22 4500 463180577 CHVBK 20180406164837.0 cr unu---uuuuu 170326e20070801xx s 000 0 eng 10.1007/s00381-007-0346-1 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0346-1 Progressive myelopathy due to meningeal thickening in shunted patients: description of a novel entity and the role of surgery [Elektronische Daten] [Matthieu Vinchon, Patrick Dhellemmes, Emmanuelle Laureau, Gustavo Soto-Ares] Introduction: Spinal cord compression due to meningeal thickening is a rare occurrence in shunted patients. Because of the long delay to clinical onset, this complication has not been identified as yet. Aims: We report on nine cases of shunt-related progressive myelopathy due to meningeal thickening (SPMMT). Materials and methods: We reviewed our database of shunted children, for cases having developed progressive tetraparesis due to cervical meningeal thickening. Results: We identified nine observations of SPMMT, eight of these with hydrocephalus due to neonatal meningitis; the last case had Dandy-Walker malformation shunted at birth and suffered postoperative meningitis. The age of clinical onset of myelopathy was between 6 and 20years (median 12.8). All patients presented with slowly progressive walking difficulties with falls and no spinal pain. Magnetic resonance imaging (MRI) showed typically a thickened dura mater with collapse of the arachnoid space, compensatory expansion of the epidural fat, and T2 hyperintensity in the spinal cord. We operated on seven patients for surgical decompression and arachnoidolysis: One died postoperatively because of shunt malfunction, and two others died later of complications of tetraplegia. Three patients were aggravated after surgery, three experienced partial improvement, but one of these subsequently deteriorated again. Conclusion: SPMMT appears to be a novel and well-defined clinical and pathological entity; its pathological and radiological features are stereotyped; however, the diagnosis is delayed because of the slow pace of the disease. Although surgical decompression may be the only option, its results were poor in our experience; earlier surgery might improve this grim prognosis. Springer-Verlag, 2007 Myelopathy nationallicence CSF shunt nationallicence Post-meningitis hydrocephalus nationallicence Vinchon Matthieu Department of Pediatric Neurosurgery, Hôpital Roger Salengro, 59037, Lille Cedex, France aut Dhellemmes Patrick Department of Pediatric Neurosurgery, Hôpital Roger Salengro, 59037, Lille Cedex, France aut Laureau Emmanuelle Laboratory of Neurophysiology, University Hospital, Lille, France aut Soto-Ares Gustavo Department of Neuroradiology, University Hospital, Lille, France aut Child's Nervous System Springer-Verlag 23/8(2007-08-01), 839-845 0256-7040 23:8<839 2007 23 381 https://doi.org/10.1007/s00381-007-0346-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0346-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vinchon Matthieu Department of Pediatric Neurosurgery, Hôpital Roger Salengro, 59037, Lille Cedex, France aut NATIONALLICENCE 700 1- Dhellemmes Patrick Department of Pediatric Neurosurgery, Hôpital Roger Salengro, 59037, Lille Cedex, France aut NATIONALLICENCE 700 1- Laureau Emmanuelle Laboratory of Neurophysiology, University Hospital, Lille, France aut NATIONALLICENCE 700 1- Soto-Ares Gustavo Department of Neuroradiology, University Hospital, Lille, France aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/8(2007-08-01), 839-845 0256-7040 23:8<839 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer