Unusual presentation of congenital dermal sinus: tethered spinal cord with intradural epidermoid and dual paramedian cutaneous ostia

Abstract

<jats:p>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.</jats:p>

Spinal cord abscess secondary to infected dorsal dermal sinus in an infant: uncommon presentation of a known entity

“…Even paramedian dimples should be examined thoroughly. Cox et al reported a case of a 7-year-old girl with two paramedian dimples and history of recurrent paraspinal soft tissue abscesses managed previously by general surgeons 7. The patient never had meningitis or intradural abscess due to which neurosurgery consultation was deferred.…”

Unusual Clinical Presentation and Association of Cranial Dermoid Tumor and Tethered Cord Syndrome

“…The rise of the spinal cord is impeded by an obstructive or a mechanical intradermal anomaly [12]. While split spinal cord syndrome, lipomyelomeningocele, short and thick filum terminale, and adherences second to surgical operations are the most frequent causes of TCS, spinal dermoid cyst and other congenital causes are determined rarely [3, 4, 13, 14]. …”

Meningite recorrente por Sinus Trato Dérmico Lombossacral

“…Em pacientes assintomáticos, o momento de abordagem cirúrgica é também indefinido, apesar de ser obrigatória a sua realização. (Efrem et al, 2012). Foi demonstrado em alguns estudos que 40% dos diagnósticos de STD são feitos em RM pré-operatória.…”