Abstract
The term spina includes several types of congenital malformations including closed spinal dysraphisms, among these 10% are dermal sinuses.Our series includes 29 patients, the majority of which were asymptomatic, but these can present with different clinical pictures including neurological and / or infectious signs indicating a neglected dermal sinus and which therefore requires urgent treatment in the environment. Neurosurgical.MRI confirmed the diagnosis showing the dermal sinus tract communicating from the surface of the skin to the intra-dural space.Once the diagnosis has been made, surgical treatment becomes imperative and urgent because, despite the benignity of the lesion, the majority of which are located in the lumbar region, can lead to formidable neurological sequelae compromising the functional prognosis or even the vital prognosis in some cases.All of our patients were operated on and we obtained 90% good results, however we deplore one case of aggravation and one death.
Highlights
The dermal sinus can manifest itself in different forms ranging from the asymptomatic form, especially in newborns or infants, to that including neurological signs associated or not with infectious signs, which is seen in older children
The dermal sinus is a lesion belonging to the closed spina; which represents 10% of closed spina according to the literature review
It is the result of the incomplete disjunction between the neuroectoderm and the cutaneous ectoderm its depth can vary from the fascia to the spinal cord, this tract lengthens during growth due to the ascent and can cross several levels in the epidural space before entering the subarachnoid spaces
Summary
Dermal sinus is a rare dysraphism that occurs in approximately one in 25,000 births [1,2-3].It is the result of incomplete obliteration of the dermal elements during the closure of the neural tube during embryonic development.They represent 10% of firm spina according to the literature review, the lumbar location is the most frequent [-5].Clinically, the dermal sinus can manifest itself in different forms ranging from the asymptomatic form, especially in newborns or infants, to that including neurological signs associated or not with infectious signs, which is seen in older children.MRI was performed in all of our patients, which confirmed the diagnosis and revealed associated lesions which can be various such as attached lower marrow, dermoid and epidermoid cysts; or abscesses of the ponytail.Despite the mildness of the lesion, the diagnosis must be made in order to avoid the installation of complications that put the functional prognosis into play, leaving definitive neurological sequelae and sometimes lifethreatening. Dermal sinus is a rare dysraphism that occurs in approximately one in 25,000 births [1,2-3] It is the result of incomplete obliteration of the dermal elements during the closure of the neural tube during embryonic development. MRI was performed in all of our patients, which confirmed the diagnosis and revealed associated lesions which can be various such as attached lower marrow, dermoid and epidermoid cysts; or abscesses of the ponytail. Despite the mildness of the lesion, the diagnosis must be made in order to avoid the installation of complications that put the functional prognosis into play, leaving definitive neurological sequelae and sometimes lifethreatening
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