Holocord intramedullary abscess due to dermal sinus in a 2-month-old child successfully treated with limited myelotomy and aspiration. Case report

Journal of Neurosurgery
Krishnapundha BunyaratavejWiroje Pongpunlert

Abstract

This 2-month-old child presented with paraplegia. The authors observed a dermal sinus with purulent discharge in the lumbosacral area. Magnetic resonance (MR) imaging of the spine revealed an intramedullary enhancing cavity spanning C-1 to the conus medullaris. Intraoperatively the dermal sinus was seen to infiltrate the lower end of the conus medullaris, and it also communicated directly with the central canal. The L2-5 laminae were removed, and a myelotomy was undertaken on the conus medullaris. A No. 8 French pediatric feeding tube was passed into the abscess cavity and advanced rostrally to the level of C-1. Aspiration was applied via the feeding tube to drain the intramedullary abscess of the spinal cord (IASC). Postoperatively, a 6-week course of intravenous cloxacillin was instituted. Follow-up MR imaging revealed complete resolution of abscess. When the patient was 26 months of age, examination showed complete neurological recovery. The authors describe what, to their knowledge, is the first case of a holocord IASC treated successfully by the aforementioned technique, and review of the related literature.

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Citations

Dec 6, 2011·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Sandeep MohindraAshish Aggarwal
Jan 28, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Moh'd Al BarbarawiAbu Alia Loai
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Jul 28, 2012·Journal of Pediatric Neurosciences·Anushirvan NiknejadMostafa El Khashab
Apr 6, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Paulo Sergio Lucas da Silva, Rafael Duarte de Souza Loduca
Nov 1, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Burak KaraaslanAlp Özgün Börcek
Sep 21, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·G Lakshmi Prasad
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Apr 18, 2007·Journal of Neurosurgery. Spine·Sandeep MohindraBishan Dass Radotra
Oct 3, 2015·Journal of Neurosurgery. Pediatrics·Shabari Girishan, Vedantam Rajshekhar

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