The spinal dermal-sinus-like stalk.
OBJECTIVE
In this study, a disjunction anomaly mimicking the spinal congenital dermal sinus (DS) is described. This anomaly is referred to as the dermal-sinus-like stalk. Dissimilarities between a true dermal sinus and a dermal-sinus-like stalk are discussed.


METHODS
Three cases in which a spinal congenital dermal sinus was suspected are presented. A similar anatomical configuration, different from that of a dermal sinus, was found. All cases presented with a skin-covered dimple from which a solid tract was seen continuing intramedullary in two cases and intraspinally in one case. None of the patients presented with signs of infection or an associated dermoid-epidermoid tumor. Clinical, radiological, and surgical findings are discussed. A hypothesis is made on the pathological genesis of this malformation.


CONCLUSIONS
A dermal-sinus-like stalk is a malformation similar to a spinal congenital dermal sinus but is not associated with DS-related complications. Despite important clinical, radiological, surgical, and histopathological differences, it is difficult to distinguish this malformation from a true DS based on clinical and radiological examination alone. Therefore, surgical intervention, at the time of diagnosis, is recommended in all cases.
van Aalst
J
J
Department of Neurosurgery, University Hospital of Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. jaspervanaalst@yahoo.com
Beuls
E A M
EA
Cornips
E M J
EM
van Straaten
H W M
HW
Boselie
A F M
AF
Rijkers
K
K
Weber
J W
JW
Vles
J S H
JS
D003937:Diagnosis, Differential; D004388:Dura Mater / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D016136:Spina Bifida Occulta / Q000175:diagnosis* / Q000601:surgery; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000601:surgery; D016135:Spinal Dysraphism / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome