Midline Dermal Sinuses and Cysts and Their Relationship to the Central Nervous System

Peter, Jonathan C.; Sinclair-Smith, C; Villiers, J. C. De

doi:10.1055/s-2008-1042463

Cited by 70 publications

(46 citation statements)

References 10 publications

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“…Controversy regarding an association with OSD and the proper evaluation and management of isolated cutaneous defects in the coccygeal region exists. 13,[15][16][17][18][19][20][21][22][23] Given the relative frequency of these cutaneous abnormalities, any statement requiring diagnostic evaluation is of public health concern. Based on our studies, it becomes difficult to recommend surgical treatment or even radiographic evaluation for isolated coccygeal pits.…”

Section: Discussionmentioning

confidence: 99%

Coccygeal Pits

Weprin

Oakes

2000

Pediatrics

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ABSTRACT. Background. Congenital dermal sinuses represent cutaneous depressions or tracts that are lined by stratified squamous epithelium. They communicate between the surface of the skin and deeper structures and may occur anywhere along the craniospinal axis. These sinuses are thought to result from abnormal separation of the cutaneous and neural ectoderm between the third and fifth week of intrauterine life. They may be often accompanied by other cutaneous stigmata, various dysraphic abnormalities, or intraspinal tumors.In the sacrococcygeal area, cutaneous congenital abnormalities are relatively common. It is estimated that 2% to 4% of children harbor intergluteal dorsal dermal sinuses. These intergluteal sinuses in the perianal region are frequently referred to as pits or dimples. Their cause is considered similar to other congenital dermal sinuses and appears unrelated to acquired pilonidal conditions observed in adults. They may become susceptible to local recurrent infection from trauma or hirsutism.Controversy regarding the evaluation and management of cutaneous defects in the coccygeal region exists.Methods. Both a literature review and a career review of clinical material were performed. Databases for articles published in English were surveyed for key words relating to coccygeal sinuses using standard computerized search techniques. The medical records of children presenting to our neurosurgical clinic for evaluation of dorsal dermal sinuses were reviewed to identify those with intergluteal sinuses.Results. In the evaluation of reported cases and of our own, we were unable to identify any children with coccygeal sinuses without other cutaneous markers other than hair with findings suggestive of intraspinal communication.Conclusions. Intergluteal dorsal dermal sinuses are relatively common lesions that frequently come to neurosurgical attention.

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Section: Discussionmentioning

confidence: 99%

Coccygeal Pits

Weprin

Oakes

2000

Pediatrics

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“…Neuro-cutaneous fistulas can develop anywhere along the central nervous system from the glabella to the lumbosacral region [4]; however, more than 95% are located in the lumbosacral and occipital regions [5]. Nasofrontal localizations are exceptional and occur in less than 5% of cases.…”

Section: Discussionmentioning

confidence: 99%

Nasofrontal Dermal Sinus with Intradiploic Epidermoid Cyst: Case Report

Nsir¹

2014

JNSK

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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%

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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Midline Dermal Sinuses and Cysts and Their Relationship to the Central Nervous System

Cited by 70 publications

References 10 publications

Coccygeal Pits

Coccygeal Pits

Nasofrontal Dermal Sinus with Intradiploic Epidermoid Cyst: Case Report

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

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