Cervical dermal sinus associated with meningitis and motor paralysis

Area of Science:

• Neurology
• Neurosurgery
• Pediatric Neurology

Background:

• Congenital dermal sinuses are rare developmental anomalies that can predispose individuals to infections.
• High cervical dermal sinuses are particularly concerning due to their proximity to the central nervous system.
• Recurrent meningitis in the presence of a dermal sinus suggests a potential tract for bacterial seeding.

Observation:

• A patient presented with a congenital dermal sinus in the high cervical region.
• The patient experienced recurrent episodes of purulent meningitis.
• Associated symptoms included fluctuating paresis of the extremities, indicating neurological compromise.

Findings:

• A direct communication between the skin and the spinal cord via the dermal sinus was suspected.
• Subtotal excision of the dermal sinus tract was performed.
• The surgical intervention resulted in a significant improvement in the patient's neurological deficits.

Implications:

• Early diagnosis and surgical intervention are crucial for managing congenital dermal sinuses.
• Complete or subtotal excision of the sinus tract can prevent recurrent infections and neurological damage.
• This case highlights the importance of considering congenital dermal sinuses in patients with recurrent meningitis and neurological symptoms.