The spinal dermal-sinus-like stalk

Childs Nerv Syst. 2009 Feb;25(2):191-7. doi: 10.1007/s00381-008-0669-6. Epub 2008 Jul 11.

Abstract

Objects: In this study, a disjunction anomaly mimicking the spinal congenital dermal sinus (DS) is described. This anomaly is referred to as the dermal-sinus-like stalk. Dissimilarities between a true dermal sinus and a dermal-sinus-like stalk are discussed.

Clinical material: Three cases in which a spinal congenital dermal sinus was suspected are presented. A similar anatomical configuration, different from that of a dermal sinus, was found. All cases presented with a skin-covered dimple from which a solid tract was seen continuing intramedullary in two cases and intraspinally in one case. None of the patients presented with signs of infection or an associated dermoid-epidermoid tumor. Clinical, radiological, and surgical findings are discussed. A hypothesis is made on the pathological genesis of this malformation.

Conclusion: A dermal-sinus-like stalk is a malformation similar to a spinal congenital dermal sinus but is not associated with DS-related complications. Despite important clinical, radiological, surgical, and histopathological differences, it is difficult to distinguish this malformation from a true DS based on clinical and radiological examination alone. Therefore, surgical intervention, at the time of diagnosis, is recommended in all cases.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Dura Mater / pathology
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging / methods
  • Spina Bifida Occulta / diagnosis*
  • Spina Bifida Occulta / surgery
  • Spinal Cord Diseases / diagnosis*
  • Spinal Cord Diseases / surgery
  • Spinal Dysraphism / pathology
  • Spinal Dysraphism / surgery
  • Treatment Outcome