[A case of diastematomyelia (split cord malformation type I) with clinical manifestation in adulthood].
We present the case of a female patient with split-cord malformation type I (diastematomyelia) who developed first symptoms as an adult and worsened markedly after intramedullary injection of local anaesthetics. Our own observations are compared with the small number of cases known from the literature. We are using the morphological and clinical classification of spinal malformations of Pang et al. (1992), which is based on a uniform disturbed embryonal development [18, 19]. The 52-year-old patient presented to her family physician in September 1991 with pain in the region of the vertebral column which had developed gradually over a period of two weeks. Following unsuccessful analgetic and muscle-relaxing therapy, the family physician had the patient transferred to the orthopedic department of a hospital. Lumbar peridural infiltrations were carried out there in February 1992 for a suspected disc prolapse. Since June 1992, she had no longer been able to walk. In addition, there had also been a progredient urinary incontinence since April 1992. The spinal CT scan reveals a duplication of spinal cord starting at the level of L4 as well as a bony spur dividing the spinal cord at levels L4 and L5. MRI of the vertebral column likewise reveals a duplication of the spinal cord starting at L4 as well as a low conus and a bone spur extending from L4 to L5 is also visualized here. Each primordial spinal cord is surrounded by its own dura mater. Altogether, this led to the diagnosis of split cord malformation type I according to Pang et al. [18].(ABSTRACT TRUNCATED AT 250 WORDS)
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Abteilung für Neurochirurgie, Universitätsklinikum Steglitz, Freie Universität Berlin.
Stendel
R
R
Rudolph
K H
KH
Brock
M
M
D005260:Female; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000175:diagnosis; D016136:Spina Bifida Occulta / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed
Ein Fall von Diastematomyelie (Split Cord Malformation Type I) mit klinischer Manifestation im Erwachsenenalter.