[On the intrathoracic meningocoele. Diagnostic usefulness of myeloscintigraphy (author's transl)].

Intrathoracic meningocoele (I.M.) consists of a bulging out of the meninges in the posterior mediastinum through an intervertebral foramen or a bone defect in the thoracic spine. It is a rare condition generally asymptomatic and often associated with von Recklinghausen's neurofibromatosis, whose aetiopathogenesis and clinical significance have not yet been completely clarified. The AA. describe a case of I.M. in a patient with neurofibromatosis who at 37 years of age presented spastic monoparesis in the left lower limb with subacute onset. In this case two abnormally wide intervertebral foramina and scalloping of the posterior rims of the vertebral bodies close to the meningocoele were observed. These changes seem to point to an alteration in bone development as the chief cause of intrathoracic meningocoele in contrast with other aetiopathogenic hypotheses. Excluding the presence of other expansive lesion, spastic monoparesis might be related to a confined medullary involvment due to compression of arterial or venous vessels by the meningocoele. Finally the AA. emphasize the importance of myeloscintigraphy, wich easily allows correct diagnosis by showing a typical pool of radioactive tracer in the meningocoele bulge lateral to the spine.