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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(02): 133
DOI: 10.1590/0004-282X20160170
IMAGES IN NEUROLOGY

Cervical spinal dermal sinus associated with intramedullary spinal cord abscess

Seio dérmico espinhal cervical associado com abscesso intramedular espinhal
Bernardo Carvalho Muniz
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil.
,
Bruno Niemeyer de Freitas Ribeiro
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil.
,
Gabriel Mufarrej
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil.
,
Nina Ventura Wilner
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil.
,
Emerson Leandro Gasparetto
1   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Radiologia, Rio de Janeiro RJ, Brasil.
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A female, aged 21 months, presented with fever and an orifice with output of purulent material, observed in the upper cervical region. Spinal and brain MRI are displayed in [Figures A to D]. The radiological diagnosis, with subsequent histopathologic confirmation, was dermal sinus associated with intramedullary spinal cord abscess.

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Figure Intramedullary spinal cord abscess characterized by a heterogeneous T2-hyperintense lesion that expands the cord, extending superiorly to the medula oblongata and inferiorly, approximately to the level of D3 (A). The lesion is predominantly hyperintense on T1, demonstrates thick peripheral enhancement (B) and true restricted diffusion (C and D). The dermal sinus is characterized by a fistulous path between the skin and the spinal cord, in this case, the cervical spine at the level of C4, with peripheral enhancement (B).

The dermal sinus is a congenital anomaly resulting from incomplete division of ectodermal epithelium with neuroectodermal, in early fetal life, and the thoraco-lumbar spine is most frequently affected. An abscess is a known complication, though rare, especially in this location[1],[2].



Publication History

Received: 28 July 2016

Accepted: 15 September 2016

Article published online:
05 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Chidambaram B, Balasubramaniam V. Intramedullary abscess of the spinal cord. Pediatr Neurosurg. 2001;34(1):43-4. http://doi.org/10.1159/000055991
  • 2 Morimoto K, Takemoto O. Nakamura H, Takeuchi M. Spinal dermal sinus associated with intramedullary abscess and dermoid. Pediatr Neurosurg. 2003;39(4):225-6. http://doi.org/10.1159/000072478