Spinal Intramedullary Abscess With an Epidermoid Secondary to a Dermal Sinus

Congenital dermal sinuses are relatively uncommon, and result from abnormal neurulation. A lack of awareness about this problem causes these patients to manifest significant mortality and morbidity. Spinal intramedullary abscesses are rare and potentially devastating lesions. Intraspinal epidermoids...

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Bibliographic Details
Published in:Pediatric neurology 2007-08, Vol.37 (2), p.144-147
Main Authors: Hung, Po-Cheng, MD, Wang, Huei-Shyong, MD, Wu, Chieh-Tsai, MD, Lui, Tai-Ngar, MD, Wong, Alex M.-C., MD
Format: Article
Language:English
Subjects:
Abscess - etiology
Abscess - pathology
Bacterial diseases
Bacterial diseases of the nervous system. Bacterial myositis
Biological and medical sciences
Human bacterial diseases
Humans
Infant
Infectious diseases
Injuries of the nervous system and the skull. Diseases due to physical agents
Magnetic Resonance Imaging
Male
Medical sciences
Neurology
Paraplegia - etiology
Paraplegia - pathology
Pediatrics
Spina Bifida Occulta - complications
Spina Bifida Occulta - pathology
Spinal Cord Diseases - etiology
Spinal Cord Diseases - pathology
Traumas. Diseases due to physical agents
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Summary:Congenital dermal sinuses are relatively uncommon, and result from abnormal neurulation. A lack of awareness about this problem causes these patients to manifest significant mortality and morbidity. Spinal intramedullary abscesses are rare and potentially devastating lesions. Intraspinal epidermoids are also unusual lesions. We report on a boy, aged 1 year and 5 months, who had a lower-back hairy hemangioma at birth without further evaluation, and dermal sinus tract without surgical intervention at age 7 months. He also manifested rapidly progressive paraplegia with urine and stool retention, and was found to have a spinal intramedullary abscess with an epidermoid as the result of a dermal sinus. This patient illustrates the importance of the recognition and evaluation of skin markers, and of an awareness and complete neurological assessment of all patients with a congenital dermal sinus, because of the potential for intradural extension and a frequent association with other dysraphic abnormalities. Prophylactic surgery is indicated to prevent dangerous and recurrent infections of the central nervous system.
ISSN:0887-8994
1873-5150
DOI:10.1016/j.pediatrneurol.2007.04.009