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Infected intraparenchymal dermoids: an underestimated entity
Sandeep Mohindra1, Rahul Gupta, Rajesh Chhabra
1Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sandeepmohindra@gmail.com
Journal of Child Neurology
|October 2, 2008
Summary
Dermal sinuses can rarely cause serious intramedullary abscesses. Prompt surgical drainage and antibiotics are key, though neurological recovery, especially bladder function, is often incomplete.
Area of Science:
- Neurology
- Infectious Diseases
- Dermatology
Background:
- Dermal sinuses are congenital abnormalities that can lead to infections.
- Infections typically manifest as superficial abscesses but can rarely extend to the central nervous system.
Purpose of the Study:
- To present the clinicoradiological findings of intramedullary abscesses secondary to dermal sinuses.
- To emphasize the role of dermal sinuses as a pathway for central nervous system infections.
- To review the management and outcomes of these rare cases.
Main Methods:
- Retrospective analysis of 19 patients with intramedullary abscesses associated with dermal sinuses.
- Review of clinical presentation, radiological imaging, microbiological data, and treatment outcomes.
- Surgical exploration, pus drainage, abscess wall excision, and prolonged antibiotic therapy.
Main Results:
- Dermal sinuses can serve as a route for infections leading to intramedullary abscesses.
- Methicillin-sensitive Staphylococcus aureus was the most common pathogen.
- Outcomes varied: 7 patients recovered fully, 7 partially, and 5 showed no improvement. Motor function improved partially, but bladder function recovery was poor.
Conclusions:
- Intramedullary abscesses secondary to dermal sinuses are rare but severe neurological complications.
- Early surgical intervention and antibiotics are crucial for management.
- Prognosis is guarded, with significant potential for long-term neurological deficits, particularly in bladder control.
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