Spinal Congenital Dermal Sinuses: A 30-Year Experience

Ackerman, Laurie L.; Menezes, Arnold H.

doi:10.1542/peds.112.3.641

Cited by 173 publications

(209 citation statements)

References 18 publications

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“…In 6% to 7% of cases, the tract reportedly terminates dorsal to the spinal elements; in 10% to 20%, it terminates Brain abscess as a manifestation of spinal dermal sinus in the extradural space, and 58% to 60% of dermal sinuses terminate in the intradural space (Keating et al 2004). With regard to these termination sites, dermal sinuses have been recognized as potential sites for the entry of bacteria into the intraspinal compartment contributing to the development of recurrent meningitis (Matson and Jerva 1966;Ackerman and Menezes 2003;Keating et al 2004).…”

Section: Discussionmentioning

confidence: 99%

Brain abscess as a manifestation of spinal dermal sinus

Emami-Naeini

Mahdavi²,

Ahmadi³

et al. 2008

TCRM

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Dermal sinuses have been associated with a wide spectrum of clinical manifestations ranging from asymptomatic to drainage of purulent material from the sinus tract, inclusion tumors, meningitis, and spinal abscess. To date, there has been no documented report of brain abscess as a complication of spinal dermal sinus. Here, we report an 8-month-old girl who was presented initially with a brain abscess at early infancy but lumbar dermal sinus and associated spinal abscess were discovered afterwards. The probable mechanisms of this rare association have been discussed.

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Section: Discussionmentioning

confidence: 99%

Brain abscess as a manifestation of spinal dermal sinus

Emami-Naeini

Mahdavi²,

Ahmadi³

et al. 2008

TCRM

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“…4,8 DST has been reported to occur in 11.34% of patients with spinal dysraphism (37 of 320 cases), while spinal dysraphism occurs in 60% to 65% of patients with DST. 9,10 The frequency of the site of DSTs has been shown as cervical 1%, thoracic 10%, lumbar 41%, lumbosacral 35%, and sacrococcygeal 13%, and that in 6% to 7% of cases, the tract reportedly terminates dorsal to the spinal elements, while in 10% to 20%, DSTs terminates in the extradural space, and in 58% to 60% dermal sinuses terminate in the intradural space.…”

Section: Discussionmentioning

confidence: 99%

“…4 Since DST is a result of focal dysjunction failure, other developmental conditions such as inclusion tumors (dermoid, epidermoid, teratoma), split cord malformations, and tethered cords have also been reported to be present. 1,3-5 As a result of such possible concomitant conditions, nerve compression or tethered cord syndrome symptoms may arise.…”

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confidence: 99%

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Infantile Lumbosacral Spinal Subdural Abscess With Sacral Dermal Sinus Tract

Park¹,

Yoon²,

Cho³

et al. 2007

Spine

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Study Design. Clinical case report of a spinal subdural abscess in an infant presenting with sacral dermal sinus tract (DST).Objectives. To suggest that sacral DST with caudal direction may require surgical resection as early as possible.Summary of Background Data. DST may induce the formation of a spinal abscess. However, it is sometimes difficult to decide on early surgical resection for DST, especially in cases that are located at a lower level than the lumbar spine and directed caudally that is not accompanied by cerebrospinal fluid leakage.Methods. A 9-month-old girl was transferred due to intermittent fever and vomiting, with the midline sinus of the lower back at the second sacral spinal level. She showed mild tenderness of the lower back and slight weakness of both lower extremities with increased residual urine volume of the bladder. Magnetic resonance imaging (MRI) showed that the low-lying sacral DST traced into the subdural space with caudal orientation, and the presence of extensive subdural spinal abscess from the first lumbar spine to the fourth sacrum.Results. Emergency resection of the sacral DST was performed after laminotomy from the first lumbar spine to the second sacrum, and the subdural spinal abscess was also surgically removed. After 8 weeks of intravenous antibiotic treatment, she showed no neurologic deficit and no evidence of residual abscess on MRI.Conclusion. We suggest that even low-lying sacral DST may require surgical resection as early as possible because it may result in indolent and extensive spinal abscesses.

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“…Coccygeal pits are small, less than 5 mm in diameter, are located in the midline within 2. cm of the anus and may be present in up to 4% of the normal population. 1,3 Sacral dimples, on the other hand, are usually larger than 5 mm in diameter, are located above the intergluteal cleft and are often found with other cutaneous markers. Current recommendations state that spinal ultrasounds should be performed in infants less than 4-6 months of age with any cutaneous marker over the spine.…”

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confidence: 99%

Recurrent meningitis in a child due to an occult spinal lesion

Au¹

2006

Canadian Medical Association Journal

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The case: A 1-year-old girl presented to hospital with fever, lethargy and vomiting. She had had an episode of Escherichia coli meningitis at 2 months of age, which had been treated with antibiotics. No further investigation was conducted at that time. The remainder of her medical history was unremarkable.On examination, the child was febrile, lethargic and cried with neck flexion. She had a port-wine stain over her lumbar spine at the midline (Fig. 1). Lumbar puncture revealed a leukocyte count of 3340 × 10 6 /L (normal value < 5 × 10 6 /L) with 78% polymorphs, an erythrocyte count of 110 × 10 6 /L, a glucose level of 1.9 mmol/L (the serum glucose level was 13.3 mmol/L) and a protein level of 0.74 g/L (normal 0.15-0.40 g/L). Results of blood and urine cultures were negative. Her cerebrospinal fluid tested positive for E. coli. In addition,

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Spinal Congenital Dermal Sinuses: A 30-Year Experience

Cited by 173 publications

References 18 publications

Brain abscess as a manifestation of spinal dermal sinus

Brain abscess as a manifestation of spinal dermal sinus

Infantile Lumbosacral Spinal Subdural Abscess With Sacral Dermal Sinus Tract

Recurrent meningitis in a child due to an occult spinal lesion

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