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Lumbar cutaneous hemangiomas as indicators of tethered spinal cords
A L Albright1, J C Gartner, E S Wiener
1Children's Hospital of Pittsburgh, PA 15213.
Insights
Lumbar cutaneous hemangiomas in children may indicate an underlying tethered spinal cord. Early diagnosis via magnetic resonance imaging is crucial, even in asymptomatic cases, to prevent potential complications.
Area of Science:
- Pediatric Neurology
- Dermatology
- Radiology
Background:
- Cutaneous hemangiomas in the lumbar region are associated with spinal cord abnormalities.
- Diagnosis of tethered spinal cord can be missed in asymptomatic children with these skin findings.
Purpose of the Study:
- To investigate the correlation between lumbar cutaneous hemangiomas and tethered spinal cords in children.
- To emphasize the importance of neuroimaging in evaluating these patients.
Main Methods:
- Retrospective review of seven pediatric patients with lumbar cutaneous hemangiomas.
- Magnetic resonance imaging (MRI) and myelography were utilized for diagnosis.
Main Results:
- All seven children, despite normal neurological exams, were diagnosed with tethered spinal cords.
- Surgical intervention confirmed the diagnosis in all cases.
- No postoperative neurological deficits were observed.
Conclusions:
- Lumbar cutaneous hemangiomas warrant neuroimaging, preferably MRI, to rule out tethered spinal cord.
- Early detection and surgical correction of tethered spinal cords can be performed safely in this population.
Abstract:
Children with cutaneous hemangiomas in the lumbar region often also have tethered spinal cords. This diagnosis can be overlooked, because children with cutaneous hemangiomas may be otherwise asymptomatic and neurologically normal. From 1983 to 1987, six consecutive children with lumbar cutaneous hemangiomas underwent magnetic resonance imaging, and a seventh had a myelogram. In all seven children, despite their normal neurologic status, tethered spinal cords were diagnosed. All children had operations, which confirmed this finding. None had postoperative neurologic deficits. Infants and children with similar lumbar cutaneous hemangiomas should have magnetic resonance scans to detect the presence of tethered spinal cords.