The Dermal Sinus: About 29 Cases and Review of the Literature

The term spina includes several types of congenital malformations including closed spinal dysraphisms, among these 10% are dermal sinuses.Our series includes 29 patients, the majority of which were asymptomatic, but these can present with different clinical pictures including neurological and / or infectious signs indicating a neglected dermal sinus and which therefore requires urgent treatment in the environment. Neurosurgical.MRI confirmed the diagnosis showing the dermal sinus tract communicating from the surface of the skin to the intra-dural space.Once the diagnosis has been made, surgical treatment becomes imperative and urgent because, despite the benignity of the lesion, the majority of which are located in the lumbar region, can lead to formidable neurological sequelae compromising the functional prognosis or even the vital prognosis in some cases.All of our patients were operated on and we obtained 90% good results, however we deplore one case of aggravation and one death.

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Congenital dermal sinus tract localized in the cervical region in an adult patient – Clinical case. Review of the literature

Interdisciplinary Neurosurgery ◽

10.1016/j.inat.2020.100683 ◽

2020 ◽

Vol 21 ◽

pp. 100683 ◽

Cited By ~ 1

Author(s):

M. Petrov ◽

V. Gerganov ◽

N. Gabrovsky ◽

M. Kamenova

Keyword(s):

Adult Patient ◽

Clinical Case ◽

Sinus Tract ◽

Cervical Region ◽

Dermal Sinus ◽

Case Review ◽

Review Of The Literature ◽

Dermal Sinus Tract ◽

Congenital Dermal Sinus

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Frontotemporal Dermal Sinus Tract with 2 Connected Intradiploic Dermoid Cysts: A Rare Case and Review of the Literature

World Neurosurgery ◽

10.1016/j.wneu.2019.03.222 ◽

2019 ◽

Vol 127 ◽

pp. 350-353

Author(s):

Ariana S. Barkley ◽

Srinivas M. Susarla ◽

Amy Lee

Keyword(s):

Rare Case ◽

Sinus Tract ◽

Dermal Sinus ◽

Review Of The Literature ◽

Dermal Sinus Tract

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Conflicting Diagnosis of Dermal Sinus Tract and Tethered Cord

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100016103 ◽

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.

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Intramedullary spinal abscess associated with intramedullary dermoid and infected dermal sinus:case report and review of the literature

Medical & Clinical Research ◽

10.33140/mcr.06.10.03 ◽

2021 ◽

Vol 6 (10) ◽

Keyword(s):

Lumbar Spine ◽

Sinus Tract ◽

Dermal Sinus ◽

Review Of The Literature ◽

Gradual Improvement ◽

Intramedullary Abscess ◽

Dermoid Sinus ◽

Dermal Sinus Tract ◽

Intradural Extramedullary ◽

Spinal Infections

Intramedullary spinal abscesses are extremely rare. Most occur secondary to cardiopulmonary spread;contiguous origin is less frequent. Few intramedullary spinal abscesses have been reported secondary to dermal sinus tracts. A dermoid sinus is a congenital lesion (closed simple dysraphism) with rare incidence.Dermoid sinuses can ease local invasion and spinal infections (meningitis, intradural extramedullary and intramedullary abscesses), usually with thoracolumbar involvement. Here we describe acase of a 20-month-old boy who presented with fever and refusal to walk 2 days prior to admission. On examination of the lumbar spine, a small sinus with skin stigmata was noted.Neurological evaluation revealed paraparesis more prominent on the left side, reduced tone and reflexes, left leg hypoesthesia,reduced anal tone, and urinary retention.MRI scan demonstrated intramedullary abscess extending from L2 to S1 level. The patient was urgently admitted for drainage of intramedullary abscess and excision of the dermal sinus tract. Proper antibiotic treatment was completed for 6 weeks with gradual improvement and ultimately full ambulation ability.

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

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0038-1653982 ◽

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.

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An unusual sequelae of an infected persistent dermal sinus tract

Child s Nervous System ◽

10.1007/s00381-006-0216-2 ◽

2006 ◽

Vol 23 (5) ◽

pp. 569-571 ◽

Cited By ~ 8

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

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

Neurosurgery ◽

10.1227/01.neu.0000290921.93588.87 ◽

2007 ◽

Vol 61 (3) ◽

pp. E661-E661 ◽

Cited By ~ 5

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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