No abstract available.
Neural Tube Defects* ; Neural Tube* ; Prenatal Diagnosis*

OBJECTIVE: The objective of this study is to determine whether the club foot of the affected fetus is related to the location, size, and rupture state of the spinal neural tube defect lesion. METHODS: Ultrasound and medical records of 21 fetuses with spinal neural tube defect were reviewed. At the time of diagnosis 7 fetuses had clubfoot and 14 fetuses didn't have. All the fetuses with spinal neural tube defect were divided into two groups, one with clubfoot fetuses, and the others without clubfoot. RESULTS: The mean lesion size of the clubfoot group was significantly larger than normal foot group (4.1+/-1.22 cm vs 2.1+/-1.59 cm). And the level of lesion is significantly higher in club foot group. But the rate of sac rupture is lower in club foot group. CONCLUSION: The fetuses with clubfoot detected at the time of diagnosis had larger size and higher level of lesion.
Clubfoot ; Diagnosis ; Fetus* ; Foot* ; Medical Records ; Neural Tube Defects* ; Neural Tube* ; Rupture ; Ultrasonography ; Ultrasonography, Prenatal*

This report presents a case of fourth ventricle neurenteric cyst (NE cyst) mimicking hemangioblastoma, which developed in a 50-year-old woman. A tiny enhancing mural portion of the fourth ventricle in MRI suggested that the cyst was hemangioblastoma, but pathological evidence showed that the cyst was in fact NE cyst in the fourth ventricle. In order to make proper decision on to what extent of surgical resection should be done, considering every possibility in differential diagnosis might be helpful. This case reports an unusual pathology in 4th ventricle, considering the patient's age, and demonstrates that a rarer disease may share radiological features of a common disease.
Diagnosis, Differential ; Female ; Fourth Ventricle* ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neural Tube Defects* ; Pathology

Lipomeningomyelocele(LMMC) is one of the most common forms of occult spinal dysraphism seen in clinical practice. It is now widely accepted that prophylactic surgery is indicated in most cases, but areas of controversies were remained. From January 1986 to December 1996, long term data are available for 57 patients who underwent surgery for LMMC repair. The most common presenting symptom of these patients were mass on back which was followed by weakness of lower extremities and bladder-bowel symptoms. Transitional type was most common(53%) and followed by caudal(28%) and dorsal type(19%). Surgical repair was performed at age of 1 month to 40 years(mean age: 48months old, median 5 months old). Follow up for these patients ranged from 10 to 130 months(mean 50.3 months). None of the patients who underwent surgery before deficits had occured had ever developed new neurological deficits at the end of the follow up. However, 8 of 57 patients(14%) had aggravation of thier initial neurologic status by history preoperatively. Those progressive symptoms were somewhat reversed or stabilized in all of them postoperatively. In addition, surgical correction in infancy provides a degree of reversibility but do not in older children. We concluded that early diagnosis and treatment should be taken to prevent these progression and permanency of neurological changes.
Child ; Early Diagnosis ; Follow-Up Studies ; Humans ; Lower Extremity ; Neural Tube Defects ; Spinal Dysraphism

Tethered cord syndrome is a kind of spinal dysraphism with low-lying conus frequently associated with intraspinal lipoma, diastematomyelia, or fibrous band. The clinical manifestations include spine abnormality such as spina bifida and variable neurological symptoms involving lower extremities and sphincters. Here are two cases of tethered cord syndrome associated with intraspinal lipoma. Both are diagnoses with CTMM (computed tomographic metrizamide myelography) and one is operated.
Conus Snail ; Diagnosis ; Lipoma ; Lower Extremity ; Metrizamide ; Neural Tube Defects ; Spinal Dysraphism ; Spine

OBJECTIVE: The authors tried to reveal some unique features of lipomeningomyelocele (LMMC), including clinical presentation, factors precipitating onset of symptoms, pathologic entities of LMMC associated with tethered cord syndrome, and surgical outcome in LMMC patients. METHODS: Seventy-five patients with LMMC were enrolled in this study. Neuro-imaging and intraoperative findings allowed classification of LMMC into three Types. The patients were divided into two groups by age : A (51 patients), from birth to 3 years, and B (24 patients), from 3 to 24 years. For prevention of retethering of the cord, a mega-dural sac rebuilding procedure was performed in 15 patients. RESULTS: During a mean postoperative follow-up period of 4 years, the surgical outcome was satisfactory in terms of improved pain and motor weakness, but disappointing with reference to the resolution of bowel and bladder dysfunction. Among these 75 patients with LMMC, preoperative deficits were improved after surgery in 29 (39%), remained stable in 28 (37%), changed slightly in 13 (17%), and worsened in 5 (7%). Patients in group A achieved better outcomes than those in group B. Depending on the type of lesion, patients with types I and II LMMC have better outcomes than those with type III LMMC. Finally, retethering of the cord with neurological deterioration occurred in 4 (5.3%) of the 75 patients, but no retethering was found in the 15 patients who were recently treated with a mega-dural sac rebuilding procedure. CONCLUSION: Our data continue to support the opinion that early diagnosis and optimal surgery are still essential for the treatment of patients with LMMC, since there is a high likelihood of residual neurological functions that can be preserved. Based on our surgical experience of untethering and decompression of lipomas, a mega-dural sac repair is useful to prevent retethering of the cord.
Classification ; Decompression ; Early Diagnosis ; Follow-Up Studies ; Humans ; Lipoma ; Neural Tube Defects* ; Parturition ; Urinary Bladder

Congenital anomalies of the spine are frequent and variable. Some are restricted to skeletal structures, while others involve combined neural tube defects or are associated with other multi-systemic disorders. Structural spinal anomalies can be classified according to their location: 1) the vertebral body, 2) the articular process, 3) the lamina with spinous process, 4) the pars interarticularis, 5) the facet joint, 6) the pedicle, or 7) other. Because of similarities between these congenital anomalies and (a) secondary changes involving infection or joint disease and (b) deformities resulting from trauma and uncertain tumorous conditions, significant confusion can occur during diagnosis. Moreover, since the anomalies often give rise to both functional impairment and cosmetic problems, appropriate treatment relies crucially on accurate diagnosis. The authors illustrate the pathogenesis and radiologic findings of the relatively common spinal anomalies confined to skeletal structures.
Congenital Abnormalities ; Diagnosis ; Joint Diseases ; Neural Tube Defects ; Spine* ; Zygapophyseal Joint

A case of intracerebral tension pneumatocele as a complication of an Osteoma in the Fronto-ethmoid sinus is reported. The commonest causes of intracranial air are head trauma and neurosurgical procedures. Less common etiologies include infection due to gas-forming organisms, mucoceles, tumors(e.g. osteomas carcinomas pituitary adenomas peripheral nerue tumors) and congenital neurenteric cysts or dural defects. Computed tomography permitted rapid diagnosis including localization of the air thus facilitating prompt treatment.
Craniocerebral Trauma ; Diagnosis ; Mucocele ; Neural Tube Defects ; Neurosurgical Procedures ; Osteoma* ; Pituitary Neoplasms

PURPOSE: Craniospinal neurenteric (NE) cysts are rare developmental non-neoplastic cysts of the central nervous system with diverse MR imaging findings. The purpose of this study was to evaluate various MR imaging findings of intracranial and intraspinal NE cysts. MATERIALS AND METHODS: We retrospectively reviewed the MR imaging findings of six NE cysts that were confirmed by pathology. We evaluated anatomic location, signal intensity, size and enhancement pattern of NE cysts. RESULTS: Two intracranial lesions were located extra-axially in the cerebellopontine angle and quadrigeminal cisterns. Three spinal lesions were intraduralextramedullary cysts, located ventral to the spinal cord, but one thoracic lesion was an intramedullary cyst. The signal intensity of the cysts was hyperintense on T1-weighted images as compared with the cerebrospinal fluid (CSF) for two intracranial lesions and one cervical lesion. In addition, all intracranial lesions showed diffusion restriction. For the remaining three spinal lesions, the signal intensity was nearly the same as the signal intensity of the CSF as seen on both T1- and T2-weighted images. On contrast-enhanced studies, two intracranial cysts showed a small nodular enhancement and one thoracic spinal lesion showed rim enhancement. CONCLUSION: NE cysts have various locations, signal intensities, and possible focal nodular or rim enhancement. Therefore, NE cysts can be included in the differential diagnosis of various craniospinal cystic or tumorous cystic lesions.
Central Nervous System ; Cerebellopontine Angle ; Diagnosis, Differential ; Diffusion ; Neural Tube Defects ; Retrospective Studies ; Spinal Cord

Congenital dermal sinus (CDS) is a type of occult spinal dysraphism characterized by a midline skin dimple. A 12-month-old girl presented with fever and ascending quadriparesis. She had a midline skin dimple in the upper sacral area that had been discovered in her neonatal period. Imaging studies revealed a holocord intramedullary abscess and CDS. Overlooking CDS or misdiagnosing it as benign sacrococcygeal dimple may lead to catastrophic infection and cause serious neurological deficits. Therefore, further imaging work-up or consultation with a pediatric neurosurgeon is recommended following discovery of any atypical-looking dimples in the midline.
Abscess* ; Diagnosis ; Female ; Fever ; Humans ; Infant ; Neural Tube Defects ; Quadriplegia ; Skin ; Spina Bifida Occulta*