Split spinal cord malformation : a case of neonate with diastematomyelia /
Split spinal cord malformation : a case of neonate with diastematomyelia /
Angela Sarmiento.
- Fairview, Quezon City: Department of Child Health, FEU-NRMF, 2011.
- photos; (in folder)
Includes appendices and bibliographical references.
Abstract: Split cord malformation or diastematomyelia is a rare and complex condition. Patients may remain asymptomatic and most of the time, diagnosis is just an incidental finding, but in =50% of cases, it tends to be associated with abnormalities of the vertebral bodies like hemivertebra, hypoplasia, kyphoscolliosis, spina bifida, and myelomeninggocele. Majority are diagnosed in infancy, with symptoms manifest at any age, usually in the second decade. The neurological symptoms can vary from pain, bowel and bladder dysfunction to motor or sensory deficits. The symptoms can be precipitated by trivial fall in an otherwise asymptomatic child. One should search for anomaly of spinal alignment, midline cutaneous anomaly, enlargement of spinal canal and echoic mass in the spinal canal (spur) in prenatal ultrasound examination. This is a case of a term, female, newborn with diastermatomyelia presenting with myelomeningocoele, delivered via spontaneous vaginal delivery with an APGAR score of 9 and 10, appropriate for gestational age to a 23 year old, primigravid, with no known comorbidity, after a pregnancy complicated by urinary tract infection on the 28th and 37th weeks age of gestation, each episode treated with Cephalexin 500mg/capsule, 1 capsule thrice a day for 7 days. Physical examination revealed a pedunculated mass at the lumbosacral area. Upon further examination and with diagnostic neuroimaging techniques using spinal CT scan spinal ultrasound, she was diagnosed with Myelomeningocoele, Diastematomyelia and Tethered cord. She underwent surgical repair of myelomeningocele, diastematomyelia, excision of bony spur and release of the tethered cord on the 8th day of life. Physical and neurologic examination upon subsequent follow ups were at par with age but an increasing head circumference was noted. monthly Cranial ultrasound revealed hydrocephalus, Chiari II thus she was scheduled for shunting.
Research - Department of Child Health
CH 2011 0004
Includes appendices and bibliographical references.
Abstract: Split cord malformation or diastematomyelia is a rare and complex condition. Patients may remain asymptomatic and most of the time, diagnosis is just an incidental finding, but in =50% of cases, it tends to be associated with abnormalities of the vertebral bodies like hemivertebra, hypoplasia, kyphoscolliosis, spina bifida, and myelomeninggocele. Majority are diagnosed in infancy, with symptoms manifest at any age, usually in the second decade. The neurological symptoms can vary from pain, bowel and bladder dysfunction to motor or sensory deficits. The symptoms can be precipitated by trivial fall in an otherwise asymptomatic child. One should search for anomaly of spinal alignment, midline cutaneous anomaly, enlargement of spinal canal and echoic mass in the spinal canal (spur) in prenatal ultrasound examination. This is a case of a term, female, newborn with diastermatomyelia presenting with myelomeningocoele, delivered via spontaneous vaginal delivery with an APGAR score of 9 and 10, appropriate for gestational age to a 23 year old, primigravid, with no known comorbidity, after a pregnancy complicated by urinary tract infection on the 28th and 37th weeks age of gestation, each episode treated with Cephalexin 500mg/capsule, 1 capsule thrice a day for 7 days. Physical examination revealed a pedunculated mass at the lumbosacral area. Upon further examination and with diagnostic neuroimaging techniques using spinal CT scan spinal ultrasound, she was diagnosed with Myelomeningocoele, Diastematomyelia and Tethered cord. She underwent surgical repair of myelomeningocele, diastematomyelia, excision of bony spur and release of the tethered cord on the 8th day of life. Physical and neurologic examination upon subsequent follow ups were at par with age but an increasing head circumference was noted. monthly Cranial ultrasound revealed hydrocephalus, Chiari II thus she was scheduled for shunting.
Research - Department of Child Health
CH 2011 0004
