Limited dorsal myeloschisis associated with dermoid elements
Sebastian Eibach1,2, Greg Moes3,4, John Zovickian1
1Paediatric Neurosurgery, Regional Centre of Paediatric Neurosurgery, Kaiser Foundation Hospitals of Northern California, Oakland, CA, USA.
Summary
Limited dorsal myeloschisis (LDM) involves a fibroneural stalk tethering the spinal cord. Complete resection of the LDM stalk, including any associated dermoid elements, is crucial to prevent further complications.
Area of Science:
- Neuroscience
- Developmental Biology
- Surgical Pathology
Background:
- Limited dorsal myeloschisis (LDM) arises from incomplete separation of neural and cutaneous ectoderm during primary neurulation.
- LDM is characterized by a fibroneural stalk tethering the spinal cord.
- Surgical treatment typically involves resection of the LDM stalk.
Purpose of the Study:
- To analyze the spectrum of Limited dorsal myeloschisis (LDM) presentations.
- To investigate the association of LDM with dermoid elements.
- To refine surgical recommendations for LDM treatment.
Main Methods:
- Retrospective review of 75 cases of Limited dorsal myeloschisis (LDM).
- Histopathological examination of LDM stalks to identify associated elements.
- Analysis of surgical outcomes and complications.
Main Results:
- Most LDM stalks contained a glioneuronal core within fibrous stroma.
- A subset of LDMs exhibited contiguous or incorporated dermoid cyst elements or dermal sinus tracts.
- Microscopic dermoid elements, if not completely resected, can lead to intradural dermoid cyst formation.
Conclusions:
- Limited dorsal myeloschisis (LDM) can be associated with dermoid elements, ranging from microscopic to extensive.
- Complete excision of the entire intradural LDM stalk, from dura to spinal cord, is recommended.
- Thorough resection prevents secondary deterioration and the need for revision surgery.
Related Concept Videos
01:19Cranial and Spinal Meninges
4.6K
The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
4.6K
01:30Neurulation
47.0K
Neurulation is the embryological process which forms the precursors of the central nervous system and occurs after gastrulation has established the three primary cell layers of the embryo: ectoderm, mesoderm, and endoderm. In humans, the majority of this system is formed via primary neurulation, in which the central portion of the ectoderm—originally appearing as a flat sheet of cells—folds upwards and inwards, sealing off to form a hollow neural tube. As development proceeds, the...
47.0K