A case of cervical diastematomyelia and syringohydromyelia in a 16-year-old female myelomeningocele patient is reported. Progressive weakness of the upper extremity led to an MR examination of the brain and spine, which revealed hydrocephalus, Chiari II malformation, cervical diastematomyelia with a syringohydromyelic cavity in each hemicord and a large dural sac in the lumbar region. Operative therapy consisted of detethering and shunting of the two syringes. Soon after surgery her symptoms improved. The need for early complete MR imaging of myelomeningocele patients presenting with new symptoms is emphasized.
We report a case of a severe form of achondrogenesis type I. Prenatal ultrasonography showed a micromelic fetus; bony structures could not be identified. Postnatal radiographs revealed some foci of ossification in the ossa ilia, the clavicles, the upper and the lower jaw and the base of the skull. The long bones, the vertebral column and the ribs were not visible. The diagnosis was established by histologic examination of the growth plates.
In cases of acute abdominal pain in girls a gynecological cause must always be considered. Neoplasms and cystic adnexal lesions complicated by hemorrhage, torsion, and infarction can be diagnosed in childhood. Ovarian tumors without endocrine activity are frequently very large at the time of discovery. Intravaginal foreign bodies, inflammation, and congenital obstructive malformations are seldom found in patients with acute abdominal pain. Ultrasound has become the diagnostic method of choice. When used by an experienced examiner, its results are nearly as good as MRI. In evaluation with clinical data and serological results, an exact diagnosis can be made by ultrasound, even if the sonomorphological pattern seems confusing. Solid adnexal mass and complex malformations require MRI as a complementary diagnostic step. X-ray studies and computed tomography are less important diagnostic tools in girls with acute abdominal pain caused by gynecological disease.
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