Spinal Dysraphism of a Baby – A Case Report (original) (raw)

Fetal Diastematomyelia: Rare Case

IOSR Journal of Dental and Medical Sciences, 2012

A ten-month-old infant with Diastematomyelia, as a very rare variety of spinal dysraphism is presented in this article Routine USG in a 36 weeks pregnant woman revealed a spinal abnormality of the fetus in thoracolumbar [D12-L1] regions. At birth, examination of the newborn showed a small midline swelling and bluish discoloration of skin and scoliosis in the lumbar region. There was associated umbilical hernia.no neurological deficit was noted. Postnatally 8 month plane radiograph showed multiple deformed dorsal vertebrae and mild scoliosis.MR imaging revealed diastematomyelia was seen at thoracolumbar [D12-L1] regions. It was type I with a bony spur measuring 1.0 X0.5 cm the two hemicords were asymmetrical. There was no cord tethering. The conus ended at the L4 level.. There was associated thoracolumbar spina bifida measuring 1.6 cm with a small meningocele measuring 2.5 X 0.6 cm. multilevel syringohydromelia and multiple deformed dorsal vertebrae and mild scoliosis of dorsal spine was seen. Thus what makes this case different is inspite of having so many microanatomical defects, there is no neurologic deficit. So its advisible to do corrective surgery to avoid further complicatiions-thethered cord syndrome before the baby starts to take steps.

Prenatal Diagnosis of Diastematomyelia: Case Reports and Review of the Literature

Prenatal Diagnosis, 1997

Diastematomyelia is a rare malformation characterized by complete or incomplete division of the spinal cord by osseous or fibrocartilaginous septum. Most cases are seen in association with other anomalies of the vertebral column such as spina bifida, kyphoscoliosis, butterfly vertebra, and hemivertebra. In this report we describe two cases of isolated diastematomyelia detected at routine second-trimester detailed ultrasound scan, the most striking feature being the detection of an echogenic focus in the posterior aspect of the spine in association with widening of the interpedicular vertebral space. The prenatal literature is reviewed to assess the clinical significance of this finding. 1997 by John Wiley & Sons, Ltd.

Prenatal diagnosis of diastematomyelia: A case report and review of the literature

Journal of Clinical Ultrasound, 2012

Diastematomyelia is a rare congenital disorder in which the spinal cord is divided longitudinally for part of its length. It can be accurately identified in the prenatal period by detailed sonographic examination of the spine. We report a case of diastematomyelia localized to spinal levels T6-T9 diagnosed prenatally at 31 weeks gestation and review the existing literature on the diagnosis and management of this condition during pregnancy.

Spinal Dysraphism; Frequency of Rare Cases of Spinal Dysmorphism in View of Mri Findings

THE PROFESSIONAL MEDICAL JOURNAL, 2017

ORIGINAL PROF-3787 ABSTRACT… Introduction: MRI plays an important role in characterising spinal dysraphisms. The reason behind this is quality of MRI showing very high contrast resolution of soft tissues and the ability to detect fat in the lesion.T2 weighted images provide excellent contrast between the sub-arachnoid spaces and neural tissue while evaluating spinal dysraphisms. Objectives: To determine the frequency of rare disorders of spinal dysraphism in view of MRI findings of spinal dyspharism patients. Study Design: retrospective. Duration: the study was conducted from 1 st September 2015 to 30 th November 2015. Settings: Radiology department, Allied hospital Faisalabad. Methods: A total of 20 consecutive pediatric age group patients presented with clinical suspicion of spinal dysraphism were included. MRI L/S spine was carried out on 1.5Tesla Philips and diagnosis of various disorders of spinal dysraphism was made. Conclusion: MRI is the first choice examination for the detection of occult spinal dysraphism. Its timely diagnosis improving surgical & medical outcome as well as better & long term care of patients with spinal dysraphism. Majority of patients in the current study had tethered cord (75%), myelomeningocele (20%), myelocele (10%), lipomyelocele (10%) Dermal sinus tract (10%) & diastematomyelia (10%) followed by associated spinal lipomas (5%), caudal agenesis (5%) & anterior meningocele (5%).

Importance of early radiologic diagnosis of congenital anomalies of the spine

Surgical Neurology, 1985

Tadmor R, Ravid M, Findler G, Sahar A. Importance of early radiologic diagnosis of congenital anomalies of the spine. Surg Neurol 1985;23:493-501. Manifest or occult spinal dysraphism in the absence of neurological symptoms is likely to remain undetected. Therefore, accurate and early diagnosis of such underlying anomalies is of prime importance for early surgical intervention in order to avoid late irreparable damage. During a period of just over 1 year, 17 such cases of spinal congenital anomalies were diagnosed by myelography with metrizamide and computed tomography-myelography. There were 16 cases of tethered cord, six with myelomeningocele, two with diastematomyelia, two with a split spinal cord, three with a lipoma, and the remaining three with vertebral anomalies. Scoliosis was present in 60%, weakness of both legs in 45%, and asymmetry of the feet in 25%. Some of these patients were initially brought to the orthopedic department for corrective surgery before undergoing a complete neurological evaluation; thus the radiologist was acting as the link between patient and neurosurgeon. Clinical experience has shown that surgical treatment can be successful and can thereby obviate further progression of neurological symptoms.

Prenatal diagnosis of diastematomyelia: presentation of eight cases and review of the literature

Ultrasound in Obstetrics and Gynecology, 2007

Objectives Diastematomyelia is a rare form of spinal dysraphism. We present eight cases of diastematomyelia diagnosed prenatally in our institution as well as a review of the literature in order to determine the prognosis of isolated cases of this very unusual condition. Methods Records of fetuses with diastematomyelia diagnosed in our institution between January 2000 and June 2005 were collected. All liveborn fetuses were examined by a pediatric neurologist. Pre-and postnatal data were analyzed. A search was then conducted using PubMed to review previously reported cases in the literature. Results Eight cases of diastematomyelia were diagnosed during the study interval. The mean (range) gestational age at diagnosis was 21 (13-25) weeks. The main sonographic findings were widening of the spinal canal in the coronal view and an additional echogenic focus in the posterior part of the spinal column in the axial view. The diagnosis of associated open spina bifida was made in one fetus with elevated levels of amniotic fluid α-fetoprotein (AF-AFP) and acetylcholinesterase (AF-AChE) and the pregnancy was terminated. The other seven cases of diastematomyelia had normal levels of AF-AFP and AF-AChE and were considered isolated. One pregnancy miscarried spontaneously 1 week following amniocentesis and the remaining six were delivered at term. Review of the literature revealed 14 reports involving 26 cases of prenatally diagnosed diastematomyelia. Twelve cases had normal biochemistry and/or no additional abnormalities and all had a favorable outcome. Conclusions When diastematomyelia is not associated with other spinal anomalies, the prognosis is favorable. Prenatal diagnosis is generally made in the second trimester but sonographic signs may be recognized as early as the first trimester. Intrauterine diagnosis of diastematomyelia should facilitate appropriate management of affected cases.

MRI diagnosis of diastematomyelia in a 78-year-old woman: Case report and literature review

Polish journal of radiology / Polish Medical Society of Radiology, 2010

Diastematomyelia is a rare congenital malformation of the spinal cord, which belongs to the group of occult spinal dysraphisms. This disorder consists in the separation of the spinal cord into two parts in the sagittal plane (hemicords). Diastematomyelia may coexist with other spinal dysraphisms, such as myelomeningocele, meningocele, spinal lipoma, neuroenteric cysts or dermal sinuses and vertebral abnormalities, such as hemivertebrae, butterfly vertebrae or scoliosis. We reported a case of a woman with a congenital defect of the spinal cord, in the form of diastematomyelia, which was diagnosed at the age of 78. The patient had been complaining of back pain for many years. The X-ray radiograms showed the fusion of vertebra L3-L4, defective fusion of posterior spinal bony elements L5-S1. Moreover, abnormal hair growth (hypertrichosis) in the lumbar region was found. The separation of the spinal cord was only diagnosed in MR imaging which was performed at the age of 78. Diastematomye...

Spinal Dysraphisms: A New Anatomical–Clinicoradiological Classification

Indian Journal of Radiology and Imaging

Background Spinal dysraphisms refer to the congenital abnormalities of the spine and spinal cord due to aberrations in the processes of gastrulation, primary neurulation, and secondary neurulation. Embryology of many complex spinal dysraphisms are yet poorly understood and there is no agreeable anatomical–clinicoradiological classification with inclusion of recently documented and complex spinal dysraphisms. Aims and Objectives The main objective of this study was to review the imaging features of spinal dysraphisms with a better understanding of embryological abnormalities and propose a new classification inclusive of all complex and unusual dysraphisms based on anatomical and clinicoradiological correlation. Materials and Methods This was a retrospective single institutional observational study of 391 cases of spinal dysraphism for 10 years in our institution. Of 391 cases included in the study, 204 were males and 187 were females. Also, 123 cases belonged to the 0–6 months age gr...