Prenatal Diagnosis of Congenital Dermal Sinus (original) (raw)
Related papers
Congenital Dermal Sinus Tract of the Spine: Experience of 16 Patients
Journal of Child Neurology, 2014
Congenital dermal sinus tract is a rare entity which lined by epithelial cells and can end anywhere between subcutaneous planes to thecal sac. These tracts may be accompanied with other pathologies such as lipomyelomeningocele, myelomeningocele, split cord malformation, tethered cord, filum abnormality and inclusion tumors and treatment includes resection of tract with intradural exploration. The authors review their experience with 16 cases. Clinical, radiological appearance and treatment of these lesions discussed with literature review.
Lumbar pseudo-tail associated with dermal sinus – A case report
Neurocirugía, 2017
Background: Lumbosacral and coccygeal skin covered appendages are a rare malformation, considered human-tails. Case report: The authors describe the case of a full term newborn girl with lumbar skin appendage and a normal neurologic examination. The magnetic resonance of the spine revealed a dermal sinus continuous with the skin appendage and with extension into to the spinal canal. Due to the infection risk, a surgery was performed on the third day of life, with dermal sinus ligation and appendage removal. At 12 months of follow-up the girl has a normal neurologic examination. Conclusions: With the description of this case the authors aim to emphasize that although rare, lumbar skin appendages can be associated with spinal dysraphism and other lesions, requiring extensive work-up and long-term surveillance.
Neurosurgical Focus, 2012
The authors present the first report of spinal congenital dermal sinus with paramedian dual ostia leading to 2 intradural epidermoid cysts. This 7-year-old girl had a history of recurrent left paramedian lumbosacral subcutaneous abscesses, with no chemical or pyogenic meningitis. Admission MRI studies demonstrated bilateral lumbar dermal sinus tracts and a tethered spinal cord. At surgery to release the tethered spinal cord the authors encountered paramedian dermal sinus tracts with dual ostia, as well as 2 intradural epidermoid cysts that were not readily apparent on MRI studies. Congenital dermal sinus should be considered in the differential diagnosis of lumbar subcutaneous abscesses, even if the neurocutaneous signatures are located off the midline.
Prenatal diagnosis of segmental spinal dysgenesis
Prenatal Diagnosis, 2007
A 20-year-old woman (gravida 1, para 0) was referred at 22 weeks and 3 days of gestation with bilateral talipes and a suspected spinal abnormality. The nuchal translucency assessed at 12 weeks and 3 days was 2.3 mm with a CRL (crown-rump length) of 59.8 mm giving an adjusted risk for Down syndrome of 1 : 825. The patient had an uneventful medical history, and no history of abdominal trauma was elicited. We performed a detailed 2D-3D ultrasound examination of the fetal anatomy. This confirmed the finding of bilateral talipes, and reduced movements across the knee joint on both sides were observed. In addition, complete disjunction of the thoracic and lumbar spine at the L1 and L2 level was seen ). There was no spina bifida or hemivertebra nor any evidence of Arnold Chiari malformation or further associated structural abnormalities.
Congenital dermal sinus of the cervical spine in an adult
Journal of Clinical Neuroscience, 2008
Congenital dermal sinuses are epithelium-lined tracts that extend from an opening in the skin through deeper tissues. Most dorsal congenital dermal sinuses are located in the lumbosacral area; a cervical location is unusual. This report describes a 24-year-old woman who presented with neck pain of 6 months' duration. A dimple in the skin over her cervical spine and a stunted right foot (0.5 cm shorter than the left) were detected on physical assessment. Neurological examination revealed increased deep tendon reflexes in her lower extremities. Magnetic resonance imaging showed a dermal sinus extending from the dimple site to the spinal cord near the C4-C5 vertebrae. Laminectomies were performed at C3-C4 and the tract was totally excised. The patient's neck pain completely resolved and her deep tendon reflexes were normal at 12 months after surgery. Tethered spinal cord alone does not necessarily demand surgery; however, if a congenital dermal sinus is present then surgery is indicated to prevent spinal infection. Even if there are no neurological symptoms, the tract must be surgically removed and the cord must be fully released to prevent future infectious or neurological complications.
MRI of fetal spinal malformations
Fetal magnetic resonance imaging is well accepted as secondary image tool for the evaluation of pathologies affecting the fetal brain as detected on prenatal ultrasonography. Significantly, fewer articles have focused on the fetal spinal canal and its contents. Many malformations and pathologies involving the spinal canal and cord may however have a significant impact on the quality of life. In addition, anomalies of the spinal cord may affect the development of the fetal brain or may be part of a more extensive malformation that may also affect the major thoracic and abdominal organs. A thorough knowledge of the normal and abnormal development of the spinal column and its contents is necessary to diagnose and understand the encountered findings. In the current review the value of fetal magnetic resonance imaging of the spinal column and cord is discussed. The most frequently encountered malformations will be presented and discussed in the context of the most relevant embryological processes.
Complicated congenital dermal sinus: Diagnosis and management
Interdisciplinary Neurosurgery, 2020
Congenital dermal sinus tracts of the spine are a rare form of spinal dysraphism, and should be considered in the differential diagnosis of lumbar subcutaneous abscesses, The CDS tracts can be associated with several pathological findings, including inclusion tumors (for example, epidermoid, dermoid, and teratoma), split-cord malformations, and tethered spinal cords. Excision of the sinus and its track with untethering of the cord should be done as early as possible to avoid intraspinal infection and abscess formation. Our study aims to find out the value of early diagnosis & rapid management of complicated CDS, to re-establish neurological function. Patients and methods: Ten cases (2 females and 8 males), with age range (13 months −4 years) presented with acute paraparesis and one case of quadriparesis, MRI spine showed spinal abscess, operative drainage was done with excision of the dermal sinus and track. Results: Neurological deficits improved in all cases, but 4 cases showed residual deficits, while the other 6 cases got complete recovery. Conclusion: Establishing diagnosis and rapid management of abscess complicating a congenital dermal sinus, is crucial to restore neurological function.
Taiwan Journal of Obstetrics and Gynecology, 2021
Objective: To modify the current neural tube defect (NTD) classification for fetal medicine specialists, and to investigate the impact of prenatal ultrasound conus medullaris position screening on the detection rate of closed spinal dysraphism and pregnancy outcomes. Materials and methods: The clinical data of 112 patients prenatally diagnosed with neural tube defects in Taiji clinic from 2008 to 2018 were retrospectively analyzed. All cases were classified following the modified classification. We compared the detection rate before and after introducing the conus medullaris screening and pregnancy outcomes for NTD types. Results: Closed spinal dysraphism type prevailed in our sample (43.8%). The median gestational age at the time of detection for cranial dysraphism was 13.3 weeks, open spinal dysraphism was 22.0 weeks, and closed spinal dysraphism was 22.6 weeks. All cranial dysraphism (n ¼ 43) and open spinal dysra-phism cases (n ¼ 20) had pregnancies terminated. For closed spinal dysraphism Class 1, the live-birth rate was 100.0% in the cases without other anomalies and 33.3% in the cases with other anomalies, respectively (X 2 ¼ 17.25, p < 0.001). Similarly, for Class 2, pregnancy continuation rate was 50.0% in cases without other anomalies and 20.0% in cases with other anomalies, yet it failed to reach statistical significance (X 2 ¼ 0.9, p ¼ 0.524). Conclusion: Our case series may help to improve early screening and prenatal diagnosis of NTDs. Modified classification is adjusted for use in ultrasound fetal care facilities, which could be used for predicting pregnancy outcome. We suggest promoting first-trimester anatomical screening in order to make an earlier diagnosis and therefore provide better prenatal care for open spinal dysraphism cases in the era of intrauterine repair. Our findings imply that the use of fetal conus medullaris position as a marker for closed spinal dysraphism improves the detection rate and would unlikely lead to a higher termination rate.
Congenital spinal dermal tract: how accurate is clinical and radiological evaluation?
Journal of Neurosurgery: Pediatrics, 2015
OBJECT A dermal sinus tract is a common form of occult spinal dysraphism. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. Clinical and radiological features can appear innocuous, leading to delayed diagnosis and failure to appreciate the implications or extent of the abnormality. If it is left untreated, complications can include meningitis, spinal abscess, and inclusion cyst formation. The authors present their experience in 74 pediatric cases of spinal dermal tract in an attempt to identify which clinical and radiological factors are associated with an infective presentation and to assess the reliability of MRI in evaluating this entity. METHODS Consecutive cases of spinal dermal tract treated with resection between 1998 and 2010 were identified from the departmental surgical database. Demographics, clinical history, and radiological and operative findings were collected from the patient ...