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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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[Dermoid cysts revealed by meningitis with medullary compression]

F Raqbi1, M Zérah, C Bodemer

  • 1Département de pédiatrie, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75345 Paris, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|June 9, 2001
PubMed
Abstract

Insights

Spinal dermal sinuses in the lumbosacral region can lead to meningitis and neural compression. Early surgical excision of these sinuses is recommended to prevent serious complications in infants and children.

Area of Science:

  • Neurology
  • Pediatric Surgery
  • Infectious Diseases

Background:

  • Spinal dermal sinus tracts in the lumbosacral region are often unrecognized, particularly when lacking external cutaneous signs.
  • These tracts pose a significant risk of meningitis due to their frequent communication with the dura mater (90% of cases).

Observation:

  • Two infants presented with meningitis, preceded by persistent constipation indicating neural compression.
  • Examinations revealed lumbosacral sinuses connected to infected dermoid or epidermoid tumors.
  • Infection involved anaerobic organisms.

Findings:

  • Surgical intervention and antibiotic treatment were administered.
  • Despite treatment, one infant experienced permanent paraplegia, highlighting the severity of potential complications.

Implications:

  • Dermal sinuses located above the intergluteal crease require prompt surgical excision upon diagnosis.
  • Timely intervention is crucial for all patients, irrespective of age or neurological status, to mitigate risks of infection and neurological damage.

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