• Neurosurg Focus · Oct 2012

    Case Reports

    Unusual presentation of congenital dermal sinus: tethered spinal cord with intradural epidermoid and dual paramedian cutaneous ostia.

    • Efrem M Cox, Kathleen E Knudson, Sunil Manjila, and Alan R Cohen.
    • Division of Pediatric Neurosurgery, Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
    • Neurosurg Focus. 2012 Oct 1;33(4):E5.

    AbstractThe authors present the first report of spinal congenital dermal sinus with paramedian dual ostia leading to 2 intradural epidermoid cysts. This 7-year-old girl had a history of recurrent left paramedian lumbosacral subcutaneous abscesses, with no chemical or pyogenic meningitis. Admission MRI studies demonstrated bilateral lumbar dermal sinus tracts and a tethered spinal cord. At surgery to release the tethered spinal cord the authors encountered paramedian dermal sinus tracts with dual ostia, as well as 2 intradural epidermoid cysts that were not readily apparent on MRI studies. Congenital dermal sinus should be considered in the differential diagnosis of lumbar subcutaneous abscesses, even if the neurocutaneous signatures are located off the midline.

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