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Composite type of split cord malformation: two different types at three different levels: case report
Kamil Melih Akay1, Yusuf Izci, Alper Baysefer
1Department of Neurosurgery, Gulhane Military Medical Academy, Ankara, Turkey.
Journal of Neurosurgery
|June 2, 2005
Summary
This study details a rare composite split cord malformation (SCM) in a child, diagnosed via whole spine MRI. Surgical intervention was successful, highlighting the importance of comprehensive spinal imaging for SCM diagnosis.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Radiology
Background:
- Split cord malformation (SCM) is a rare congenital anomaly of the spinal cord.
- Composite SCM, involving multiple types of SCM, is exceptionally rare.
- Accurate diagnosis and classification are crucial for appropriate management.
Observation:
- A pediatric patient presented with symptoms mimicking a common cold.
- Diagnostic imaging, including CT and whole spine MRI, revealed a composite SCM.
- The malformation exhibited Type I SCM at T-4/T-5 and Type II SCM at T-12, per Pang's classification.
Findings:
- The patient underwent successful surgical resection of the splitting lesions and terminal filum release.
- This case represents the first documented instance of a composite-type SCM with this specific configuration.
- Post-operative recovery was uneventful, with symptom resolution.
Implications:
- The findings underscore the diagnostic utility of whole spine MRI in evaluating SCM.
- Comprehensive imaging is recommended to detect potential co-existing SCM types.
- Early diagnosis and surgical intervention can prevent long-term neurological and urological complications.