Sonographic Evaluation of a Dermal Sinus Tract (Occult Spinal Dysraphism)

1999 ◽  
Vol 15 (3) ◽  
pp. 116-118
Author(s):  
Gabe Pritchett
Keyword(s):  
Spinal Dysraphism ◽  
Sinus Tract ◽  
Dermal Sinus ◽  
Occult Spinal Dysraphism ◽  
Sonographic Evaluation ◽  
Dermal Sinus Tract

scholarly journals Use of magnetic resonance imaging to detect occult spinal dysraphism in infants

2017 ◽  
Vol 19 (2) ◽  
pp. 217-226 ◽  
Author(s):  
Brent R. O'Neill ◽  
Danielle Gallegos ◽  
Alex Herron ◽  
Claire Palmer ◽  
Nicholas V. Stence ◽  
...  
Keyword(s):  
Congenital Anomalies ◽  
Imaging Modality ◽  
Spinal Dysraphism ◽  
Sinus Tract ◽  
Conus Medullaris ◽  
Dermal Sinus ◽  
Occult Spinal Dysraphism ◽  
Disc Space ◽  
Dermal Sinus Tract ◽  
Study Population

OBJECTIVE Cutaneous stigmata or congenital anomalies often prompt screening for occult spinal dysraphism (OSD) in asymptomatic infants. While a number of studies have examined the results of ultrasonography (US) screening, less is known about the findings when MRI is used as the primary imaging modality. The object of this study was to assess the results of MRI screening for OSD in infants. METHODS The authors undertook a retrospective review of all infants who had undergone MRI of the lumbar spine to screen for OSD over a 6-year period (September 2006–September 2012). All images had been obtained on modern MRI scanners using sequences optimized to detect OSD, which was defined as any fibrolipoma of the filum terminale (FFT), a conus medullaris ending at or below the L2–3 disc space, as well as more complex lesions such as lipomyelomeningocele (LMM). RESULTS Five hundred twenty-two patients with a mean age of 6.2 months at imaging were included in the study. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in 28 (5%), other isolated cutaneous stigmata (subcutaneous lipoma, vestigial tail, hairy patch, and dysplastic skin) in 31 (6%), several of the above stigmata in 97 (18%), and congenital anomalies in 50 (10%). Twenty-three percent (122 patients) of the study population had OSD. Lesions in 19% of these 122 patients were complex OSD consisting of LMM, dermal sinus tract extending to the thecal sac, and lipomeningocele. The majority of OSD lesions (99 patients [81%]) were filar abnormalities, a group including FFT and low-lying conus. The rate of OSD ranged from 12% for patients with asymmetrically deviated gluteal crease to 55% for those with other isolated cutaneous stigmata. Isolated midline dimple was the most common indication for imaging. Among this group, 20% (46 of 235) had OSD. There was no difference in the rate of OSD based on dimple location. Those with OSD had a mean dimple position of 15 mm (SD 11.8) above the coccyx. Those without OSD had a mean dimple position of 12.2 mm (SD 19) above the coccyx (p = 0.25). CONCLUSIONS The prevalence of OSD identified with modern high-resolution MRI screening is significantly higher than that reported with US screening, particularly in patients with dimples. The majority of OSD lesions identified are FFT and low conus. The clinical significance of such lesions remains unclear.

Conflicting Diagnosis of Dermal Sinus Tract and Tethered Cord

2013 ◽  
Vol 40 (6) ◽  
pp. 889-891
Author(s):  
Chris J. Hong ◽  
Saleh A. Almenawer ◽  
Boleslaw Lach ◽  
Nina Stein ◽  
Benedicto Baronia ◽  
...  
Keyword(s):  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Sinus Tract ◽  
Neural Tube Closure ◽  
Dermal Sinus ◽  
Lumbar Region ◽  
Occult Spinal Dysraphism ◽  
Developmental Abnormalities ◽  
Skin Tags ◽  
Dermal Sinus Tract

Dermal sinus tracts (DSTs) are an uncommon form of occult spinal dysraphism that is attributed to incomplete neural tube closure during fetal development. Dermal sinus tracts are found along the midline neuroaxis from the nasion to the coccyx, but they most commonly appear in the lumbar region. Dermal sinus tracts are more commonly associated with other developmental abnormalities such as skin tags, naevi, spinal dermoid cysts, meningocoele, lipomas and spinal cord tethering, and can be complicated by cerebrospinal fluid drainage, shedding of keratin from the epithelialized tract, and infection such as meningitis.

Spinal Dermal Sinus Tract

2019 ◽  
pp. 47-55
Author(s):  
Nathan R. Selden
Keyword(s):  
Imaging Modality ◽  
Spinal Dysraphism ◽  
Cauda Equina ◽  
Sinus Tract ◽  
Conus Medullaris ◽  
Dermal Sinus ◽  
Dermal Sinus Tract ◽  
Long Term Follow Up ◽  
Operative Assessment ◽  
Spinal Dermal Sinus

Spinal dermal sinus tract is a rare form of spinal dysraphism that presents occasionally with signs of spinal tethering and rarely with repeated bouts of bacterial meningitis or fulminant pyogenic infection of the conus medullaris or cauda equina leading to serious loss of neurologic function. Physical examination is crucial to accurately diagnose cutaneous findings such as the presence of a pit or tract, in order to avoid subsequent neurological sequelae. Spinal MR imaging is the only definitive imaging modality for the diagnosis of spinal dermal sinus tract and surgical planning for its excision. Total removal of all dermoid tract material is necessary to prevent recurrence. Careful peri-operative assessment and long-term follow-up will optimize outcomes and minimize complications.

scholarly journals SPINAL DYSRAPHISM;

2017 ◽  
Vol 24 (04) ◽  
pp. 565-573
Author(s):  
Bushra Ujala ◽  
Saeeda Bano ◽  
Asma Mehreen ◽  
Hassan Bukhari
Keyword(s):  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Sinus Tract ◽  
Radiology Department ◽  
Dermal Sinus ◽  
Pediatric Age Group ◽  
First Choice ◽  
Dermal Sinus Tract

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 tissuesand the ability to detect fat in the lesion.T2 weighted images provide excellent contrastbetween 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 MRIfindings of spinal dyspharism patients. Study Design: retrospective. Duration: the study wasconducted from 1st September 2015 to 30th November 2015. Settings: Radiology department,Allied hospital Faisalabad. Methods: A total of 20 consecutive pediatric age group patientspresented with clinical suspicion of spinal dysraphism were included. MRI L/S spine was carriedout 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 careof 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%).

scholarly journals Isolated extramedullary intradural thoracic epidermoid cyst: A rare case report

2021 ◽  
Vol 7 (3) ◽  
pp. 81-84
Author(s):  
Anuj Kumar Tripathi ◽  
Zahwa Rizwan ◽  
Shagufta Tahir Mufti ◽  
Saurabh Patahak ◽  
Om Prakash Gupta ◽  
...  
Keyword(s):  
Epidermoid Cyst ◽  
Spinal Dysraphism ◽  
Young Male ◽  
Sinus Tract ◽  
Interesting Case ◽  
Dermal Sinus ◽  
Rare Case Report ◽  
Dermal Sinus Tract ◽  
History Of ◽  
Or History

Spinal epidermoid cyst is a rare entity. It may be congenital with associated spinal dysraphism such asspina bifida ,dermal sinus tract and other neural tube defects or acquired due to repeated lumbar puncture and trauma. Congenital spinal epidermoid cysts without spinal dysraphism are rare. Here we are reporting a rare and interesting case of thoracic extramedullary intradural epidermoid cyst with no associated features of spinal dysraphism or history of iatrogenic trauma in a young male patient.

scholarly journals P.234 “Inappropriate” spinal ultrasounds for suspected occult spinal dysraphism in northern Alberta

2021 ◽  
Vol 48 (s3) ◽  
pp. S88-S88
Author(s):  
M Keough ◽  
A Thompson ◽  
V Mehta
Keyword(s):  
Imaging System ◽  
Spinal Dysraphism ◽  
Sinus Tract ◽  
Choosing Wisely ◽  
Dermal Sinus ◽  
Mri Imaging ◽  
Occult Spinal Dysraphism ◽  
Cutaneous Manifestations ◽  
Family Doctors ◽  
Dorsal Appendage

Background: Occult spinal dysraphism (OSD) may be associated with visible cutaneous manifestations. A common non-pathological mimic of a dermal sinus tract is an incidental sacrococcygeal dimple. Choosing Wisely Canada Guidelines recommend these dimples not be imaged. Methods: This study assessed the appropriateness of spinal ultrasounds performed for the investigation of an OSD. We interrogated our local imaging system to analyze spinal ultrasounds being performed in babies less than 6 months of age, from 2017-2018. Results: 429 children had spinal ultrasounds ordered by pediatricians (55%), family doctors (21%), and neonatologists (20%). 183 children (43%) had imaging indications that was deemed “inappropriate”. Some of this cohort had further MRI imaging (5/183) or neurosurgical referral (8/183). None of these children underwent neurosurgery. 231 (54%) children had appropriate indications for imaging. Within this cohort MRI imaging (23/231), neurosurgical referral (24/231) and neurosurgical intervention occurred (4/231). All four “surgical children” harboured either a dorsal appendage or a subcutaneous lipoma. We estimated, declining inappropriate scans would save $22, 500 annually. Conclusions: A significant portion of local spinal ultrasound requests for OSD are inappropriate. Collaboration with other sites is ongoing to investigate if the Choosing Wisely guidelines for imaging this patient population are being practiced more efficiently.

scholarly journals Congenital anomalies of the vertebrae in dogs

2017 ◽  
Vol 86 (2) ◽  
pp. 105-118 ◽  
Author(s):  
L. De Rycke ◽  
J. H. Saunders
Keyword(s):  
Congenital Anomalies ◽  
Spinal Dysraphism ◽  
Sinus Tract ◽  
Spinal Reflexes ◽  
Dermal Sinus ◽  
Limb Ataxia ◽  
Neurological Problem ◽  
Dermal Sinus Tract ◽  
Vertebral Anomalies ◽  
Pelvic Limb

In this review article, a overview is given of the congenital pathologies of vertebrae in the dog. These pathologies are common in dogs and can be divided in two major groups: neural tube defects or spinal dysraphism, such as spina bifida with or without meningocoele and dermal sinus tract, and congenital anomalies of the vertebral column. The latter group can be subdivided in malformations originating in the embryonic period of development, such as butterfly vertebra, mediolateral wedged vertebra and transitional vertebra, or in the foetal period, such as block vertebra and dorsoventral wedged vertebra. Congenital vertebral anomalies can be incidental findings on radiographs or CT, but sometimes they can be the underlying cause of a clinical, mostly neurological problem. Due to pressure on the spinal cord, symptoms, such as pelvic limb ataxia, paresis, loss of spinal reflexes, incontinence and atrophy of the pelvic limbs may occur.

Prevotella melaninogenica Meningitis and Abscess: A Complication of the Removal of a Midline Dermoid Cyst

2018 ◽  
Vol 15 (03) ◽  
pp. 152-154
Author(s):  
Megan B. Garcia ◽  
Anjali N. Kunz
Keyword(s):  
Dermoid Cyst ◽  
Bacterial Infections ◽  
Surgical Excision ◽  
Sinus Tract ◽  
Neural Tube Closure ◽  
Intracranial Extension ◽  
Dermal Sinus ◽  
Oral Flora ◽  
Prevotella Melaninogenica ◽  
Dermal Sinus Tract

Abstract Prevotella species are gram-negative anaerobic commensal bacteria of the oropharynx, which frequently cause periodontal disease but are otherwise rarely implicated in serious bacterial infections. Cranial dermoid cysts are benign neoplasms that grow along the planes of the embryonic neural tube closure. In infants, they most commonly present in frontal locations, including periorbital, nasal, and within the anterior fontanelle. Although dermoid cysts are slow growing, usually uncomplicated, and easily treated definitively with surgical excision, cranial cysts located on the midline are associated with a higher risk for persistent dermal sinus tract with intracranial extension of the tumor. We describe a case of a 10-month-old male patient with an occipital midline dermoid cyst with intracranial extension, infected with Prevotella melaninogenica, and complicated by intracranial abscess formation and meningitis.This case highlights two unusual disease entities: the uncommon occipital location of a dermoid cyst, and complications of that cyst caused by a serious bacterial infection with a normal oral flora. We discuss the recommendation for neuroimaging prior to surgical excision of a midline dermoid cyst, given the risk for dermal sinus tract with intracranial communication. We also discuss potential mechanisms for bacterial inoculation of this cyst with Prevotella melaninogenica. This pathogen has not previously been reported as a complication of dermoid cysts.

An unusual sequelae of an infected persistent dermal sinus tract

2006 ◽  
Vol 23 (5) ◽  
pp. 569-571 ◽  
Author(s):  
R. Shane Tubbs ◽  
Philip K. Frykman ◽  
Carroll M. Harmon ◽  
W. Jerry Oakes ◽  
John C. Wellons
Keyword(s):  
Sinus Tract ◽  
Dermal Sinus ◽  
Dermal Sinus Tract

CONGENITAL PTERIONAL DERMAL SINUS IN AN 18-MONTH-OLD CHILD

Neurosurgery ◽  
2007 ◽  
Vol 61 (3) ◽  
pp. E661-E661 ◽  
Author(s):  
William J. Mack ◽  
Saadi Ghatan
Keyword(s):  
Clinical Features ◽  
Neural Tube ◽  
Clinical Presentation ◽  
Sinus Tract ◽  
Dermal Sinus ◽  
Operating Microscope ◽  
First Case ◽  
Dermal Sinus Tract ◽  
Cranial Fossa ◽  
Congenital Dermal Sinus

Abstract OBJECTIVE Congenital dermal sinus tracts most frequently occur in the midline and are often associated with dermoid or epidermoid inclusion cysts. A lateral cranial origin is extremely rare and anatomically inconsistent with an etiology involving closure of the rostral neural tube during embryogenesis. CLINICAL PRESENTATION We describe the first case of a pterional cranial dermal sinus tract associated with a small epidermoid, with extension to the dura of the anterior cranial fossa. INTERVENTION The extra- and intracranial portions of the tract were visualized and resected with the use of an operating microscope. Pathological diagnosis confirmed dermal sinus tract. CONCLUSION We review the existing literature and address the developmental and clinical features pertinent to the management of cranial dermal sinus tracts, emphasizing the need for exploration of these potentially harmful lesions.

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