1/5. adult onset of tethered spinal cord syndrome due to fibrous diastematomyelia: case report.adult onset of the symptoms of tethered spinal cord is a rare entity that is occasionally associated with diastematomyelia. Only one case of fibrous diastematomyelia in an adult has been reported. The fibrous nature of this disease may present a diagnostic difficulty. A 32-year-old man with the adult onset of impairment of sacral functions with lumbar fibrous diastematomyelia is reported. Surgical release of the spinal cord was followed by improvement of the patient's function.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/5. Limitations of amniography in the prenatal diagnosis of spina bifida.A fetus with an open, noncystic myelomeningocele was detected at the 22nd week of gestation in a woman monitored for advanced maternal age. The lesion could not be demonstrated on amniography. In 13% of published reports amniography failed to detect significant spina bifida lesions. This false-negative rate seems related to the noncystic nature of some neural tube defects at midgestation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/5. Craniocervical intradural neurenteric cysts.Neurenteric cysts are rare lesions of the central nervous system that are lined by epithelium of intestinal nature. They result from abnormal separation of germ cell layers in the 3rd week of embryonic life, leading to persistence of entodermal elements in the spinal canal. The common location is cervical and ventral to the spinal cord. The lesions have been recognized as being entodermal in origin by such markers as vertebral anomalies, gut cysts, bowel reduplication and the presence of keratin markers. Three unusual cases of childhood craniocervical intradural neurenteric cysts in patients aged 4-8 years are described. These cysts were located in the ventral aspect of the spinal canal ranging from the craniocervical junction to the C6 level and were associated with bony anomalies such as a bifid clivus, hemivertebrae and blocked vertebrae. Two patients presented with signs of cervical cord compression and 1 with recurrent meningitis. One child with an anterior cervicomedullary region mass had undergone unsuccessful transoral transpalatal exploration and subsequently required excision with a dorsolateral approach. The second patient, after two successful attempts at drainage via laminectomies, required myelotomy of the spinal cord to allow excision. Thus the patient with the lesion from C4 through C6 underwent vertebrectomy and anterior excision with a C4 through C7 strut graft fusion. There were bony and vascular anomalies which would have complicated a dorsal approach. Pathological diagnosis of neurenteric cysts was based on the findings of nonciliated mucin producing small cuboidal or columnar epithelium lining a cystic cavity. Neurenteric cysts are uncommon congenital anomalies which may become symptomatic in the pediatric population.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/5. Intradural neurenteric cyst at the craniovertebral junction.A case of an intraspinal neurenteric cyst at the craniovertebral junction in a 7-year-old girl is reported. The intermittent progression of her neurological symptoms delayed the diagnosis. The location and cystic nature of the lesion were diagnosed with magnetic resonance imaging. Total surgical excision of the cyst was possible.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/5. Extradural dermoid tumours of the posterior fossa.Dermoid tumours in children usually occur in two locations: at the anterior fontanelle and on the occipital squama. An exceptional site of origin for a posterior fossa dermoid cyst is the extradural space. There are only six previous cases of this situation reported in the literature. A series of 103 subscalp and calvarial masses in children were reviewed and three children are reported with extradural dermoids of the posterior fossa, which communicated with the skin through midline occipital dermal sinuses. All three children were seen after the rapid growth or the formation of an abscess in a previously noted occipital subcutaneous mass present since birth. Although computed tomography or magnetic resonance imaging showed the dermal sinus and the intracranial tumour, these studies were unable to ascertain the intradural or extradural nature of the tumours, their exact origin only being established at operation. Histopathological study showed preclinical signs of infection in the two patients that had not yet formed an abscess. It is suggested that early neurosurgical treatment of these neoplasms should be done to prevent the development of severe intracranial infection. The previously reported simplicity of surgical removal of occipital extradural dermoids was not confirmed in this series.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |