Dermal sinus and intramedullary spinal cord abscess

Morandi, Xavier; Mercier, Philippe; Fournier, Henri-Dominique; Brassier, G.

doi:10.1007/s003810050370

Cited by 91 publications

(77 citation statements)

References 14 publications

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“…Early stage excision of dermal sinus tracts determined with physical examination and imaging methods may prevent the development of progressive and destructive infections in the patient (4). The most frequently seen complication in CSDS patients is meningitis and the least seen but most severe complication is intramedullary abscess (IMA) (1). While IMA may be seen at any age it is most often seen in children below the age of 5 years [6].…”

Section: Discussionmentioning

confidence: 99%

“…In the current case, diagnosis was not made until the age of 18 months and the patient had been given several antibiotic treatments as there was redness, swelling and discharge in the lumbosacral region and the onset of fever 40 days prior to presentation. The complication of Several authors have recommended early surgery for these patients [1,2,4]. Drainage of the abscess with laminectomy and dorsal midline myelectomy is an effective method for the control of infection and functional recovery [2].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of CSDS has been reported as 1 per 2500 births at similar rates for both genders. It may be seen in any location from the occipital region to the coccyx, although it is observed most often in the lumbar and sacral regions [1,2]. There may be accompanying skin colour change, increased hairiness or sacral dimple and the most evident sign is a sinus orifice on the skin.…”

Section: Introductionmentioning

confidence: 99%

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Spinal intramedullar cord abscess which developed as a result of congenital spinal dermal sinus

Altun¹,

Yüksel²

2017

Pau Med J

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Dermal sinus is a type of spina bifida occulta which develops as a result of incomplete separation of the cutaneous ectoderm from the underlying neural ectoderm. It generally has sacral location and may be accompanied by colour change, increased hairiness and sacral dimple. In half of cases the sinus may be associated with the spinal canal. Dermal sinus infection as a result of this may cause dramatic outcomes such as paraplegia and myelitis. The case is here presented of an 18-month old female infant who had started a fever 40 days previously, was taken to a doctor and treatment of antibiotics and antipyretics was started for a diagnosis of pharyngitis but the high fever continued despite the treatment. After 20 days, redness and swelling on the back was noticed together with the fever and as there was a yellow-coloured discharge from the area of the swelling, the doctor was again consulted and the antibiotics were changed. The patient was then brought to our clinic, as in the previous 3 days, there had been increasingly reduced movement of the feet. As a result of tests applied to the patient, intramedullary abscess was determined. In neonates and infants, the spinal area must be evaluated well. It must be kept in mind that in patients with colour change, increased hair and especially sacral dimple, there could be midline closure defects. Pam Med J 2017;10(2):188-191Key words: Dermal sinus, Sacral dimple, Abscess, Early diagnosis. ÖzetDermal sinus, spina bifida occultanin bir tipi olup kütanöz ektoderm ile altinda bulunan nöral ektodermin ayrilmasinin tamamlanamamasi sonucu gelişir.Genellikle sakral yerleşimlidir ve ciltte renk değişikliği, killanma artişi,sakral gamze eşlik edebilir. Olgularin yarisinda sinüs spinal kanal ile ilişkili olabilir. Bunun sonucu olarak dermal sinüs enfeksiyonu, parepleji, myelit gibi dramatik sonuçlara neden olabilir. Bir buçuk yaşinda kiz hasta 40 gün öncesinde ateşi başlamiş ve başvurduğu doktor tarafindan farenjit tanisiyla antibiyotik ve ateş düşürücü tedavisi başlanmiş ancak tedaviye rağmen ateş yüksekliği devam etmiş. Yirmi gün önce ateş yüksekliği ile birlikte sirtinda kizariklik ve şişlik fark edilmiş ve şişlik yerinden sari renkli akinti gelmesi üzerine tekrar başvurduğu doktor tarafindan antibiyotiği değiştirilmiş. Son üç gündür giderek artan ayak hareketlerinde azalma nedeniyle kliniğimize başvuran ve yapilan tetkikler sonucu intramedüller apse tespit edilen hasta sunuldu. Yenidoğan dönemindeki hastalarda spinal bölge iyi değerlendirilmeli, renk değişikliği, killanma artişi ve özellikle sakral gamzesi olan hastalarda orta hat kapanma defektleri olabileceği akilda tutulmalidir. Derg 2017;(2):188-191 Pam Tıp

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spinal intramedullar cord abscess which developed as a result of congenital spinal dermal sinus

Altun¹,

Yüksel²

2017

Pau Med J

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“…In the cases reviewed by Chan and Gold, 3 all the patients were managed with surgical intervention at presentation, which is also the preferred timing of surgery reported by others. 1,10,14,19 However, there is no mention in the literature regarding the duration of antibiotic therapy before or after surgical drainage.…”

Section: Surgery and Outcomementioning

confidence: 99%

“…1,5,10,18 The aims of surgery are to obtain a diagnosis, ascertain the causative organism if not already determined through culture of sinus wound discharge, drain the abscess, excise the wall of the dermoid cyst as much as safely possible, and remove the source of infection (dermal sinus). We prefer to perform surgery early in children with a diagnosis of dermal sinus with or without an intraspinal dermoid cyst.…”

Section: Surgery and Outcomementioning

confidence: 99%

Rapid-onset paraparesis and quadriparesis in patients with intramedullary spinal dermoid cysts: report of 10 cases

Girishan

Rajshekhar

2016

Journal of Neurosurgery: Pediatrics

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OBJECT Intramedullary dermoid cysts are rare tumors of the spinal cord. Presentation with rapid onset of paraparesis or quadriparesis (onset within 2 weeks) is rarer still. The authors present their experience in the management and outcome of patients with such a presentation. METHODS Patient records between 2000 and 2014 were retrospectively reviewed to identify those with intraspinal dermoid cysts who presented with rapid-onset paraparesis or quadriparesis. Their clinical, radiological, operative, and follow-up data were analyzed. RESULTS Of a total of 50 patients with intraspinal dermoid cysts managed during the study period, 10 (20%) presented with rapid-onset paraparesis or quadriparesis; 9 patients ranged in age from 8 months to 2 years, and 1 patient was 25 years old. A dermal sinus was seen in the lumbar region of 4 patients, the sacral region of 3, and the thoracic region of 1, and in 1 patient no sinus was found. All except 1 patient presented with rapid-onset paraparesis secondary to infection of the intramedullary dermoid cyst. One patient presented with rupture of a dermoid cyst with extension into the central canal up to the medulla. Early surgery was done soon after presentation in all except 2 patients. Among the 9 patients who underwent surgery (1 patient did not undergo surgery), total excision of the intramedullary dermoid cyst was done in 3 patients, near-total excision in 4 patients, and partial excision in 2 patients. Of the 9 patients who underwent surgery, 8 showed significant improvement in their neurological status, and 1 patient remained stable. The 1 patient who did not undergo surgery died as a result of an uncontrolled infection after being discharged to a local facility for management of wound infection. CONCLUSIONS Early recognition of a dermal sinus and the associated intraspinal dermoid cyst and timely surgical intervention can eliminate the chances of acute deterioration of neurological function. Even after an acute onset of paraparesis or quadriparesis, appropriate antibiotic therapy and prompt surgery can provide reasonably good outcomes in these patients.

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Pediatric (Nontuberculous) Spinal Infections

Deopujari¹,

Mohanty²

2017

Textbook of Pediatric Neurosurgery

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Dermal sinus and intramedullary spinal cord abscess

Cited by 91 publications

References 14 publications

Spinal intramedullar cord abscess which developed as a result of congenital spinal dermal sinus

Spinal intramedullar cord abscess which developed as a result of congenital spinal dermal sinus

Rapid-onset paraparesis and quadriparesis in patients with intramedullary spinal dermoid cysts: report of 10 cases

Pediatric (Nontuberculous) Spinal Infections

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