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Occult dysraphism in adulthood: clinical course and management
J Klekamp1, A J Raimondi, M Samii
1Abteilung für Neurochirurgie, Nordstadt-Krankenhaus, Medizinische Hochschule Hannover, Germany.
Summary
This study on adult-onset dysraphic malformations found that surgical intervention improved meningoceles. Spinal hamartomas with paraparesis had better outcomes than those causing pain, with lower recurrence rates.
Area of Science:
- Neurology
- Neurosurgery
- Developmental Biology
Background:
- Dysraphic malformations typically present in childhood.
- Adult onset of these conditions is less common but can cause significant morbidity.
Purpose of the Study:
- To describe the clinical presentation, management, and outcomes of adult patients with dysraphic malformations.
- To compare outcomes between different types of malformations and presenting symptoms.
Main Methods:
- Retrospective case series of 23 adult patients with dysraphic malformations.
- Surgical intervention for progressive neurological disease; conservative management for others.
- Classification of spinal hamartomas based on primary symptom (paraparesis vs. pain).
Main Results:
- 23 patients with adult-onset dysraphic malformations (4 meningoceles, 19 spinal hamartomas) were analyzed.
- Surgical treatment of meningoceles led to improvement without recurrence.
- Spinal hamartomas presenting with paraparesis (Group A) showed better long-term results than those with pain (Group B), attributed to lower recurrence rates.
- Group B hamartomas were more complex and associated with tethered cords.
Conclusions:
- Dysraphic malformations can present in adulthood with varied symptoms.
- Surgical and conservative management approaches are effective depending on the specific malformation and progression.
- Spinal hamartomas causing paraparesis have a more favorable prognosis than those causing pain.
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