Fact-sheet: Dorsal dermal sinus
Updated on 07/14/2016 at 10:28 AM
View all RADEOS cases associated with this fact-sheet
Definition
Epithelialized tract extending from a skin dimple to the spinal canal.
This is a closed spinal dysraphism: covered by skin
Clinical features
Small midline dimple +/- small angioma +/- soft tissue asymmetry
often associated with intraspinal lipomas, low tethered cord.
May be located at any level but sacrococcygeal ++
Possible CSF leakage when communicating
Risk of infectious, neurological, or orthopedic complications, which may also reveal it.
Recurrent meningitis or meningitis due to unusual organisms is a very common presenting feature in young children.
Various neurological signs, ranging from simple hyporeflexia to paraplegia, or to bladder-sphincter disorders. Signs generally subtle in young children (delayed acquisition of walking or continence).
Rare orthopedic abnormalities: clubfoot or equinovarus foot, limb length asymmetry, scoliosis.
Ultrasound
Straight hypoechoic tract,
CT
Examination not performed as first-line,
hypodense tract
MRI
T1-T2 hypointense tract
Management
Surgical management
Surgical complications are rare and justify performing surgery as early as possible in life.
Classification
Closed dysraphism: covered by intact skin
* With subcutaneous mass
1-Lipomyelocele
2-Lipomyelomeningocele
3-Meningocele
4-Terminal myelocystocele
* Without subcutaneous mass
- Simple dysraphic states:
1-Intradural lipoma
2-Lipoma of filum terminale
3-Thickened filum terminale
4-Persistent ventriculus terminalis
5-Dermal sinus
- Complex dysraphic states:
1-Neurenteric cyst
2-Diastematomyelia
3-Caudal agenesis
Open dysraphism: not covered by intact skin
1-Myelocele
2-Myelomeningocele
3-Hemimyelocele
4-Hemimyelomeningocele
