title: The spinal dermal-sinus-like stalk.
abstract: 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.
authors.affiliation: Department of Neurosurgery, University Hospital of Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. jaspervanaalst@yahoo.com
authors.forename: J
authors.initials: J
authors.lastname: van Aalst
authors.forename: E A M
authors.initials: EA
authors.lastname: Beuls
authors.forename: E M J
authors.initials: EM
authors.lastname: Cornips
authors.forename: H W M
authors.initials: HW
authors.lastname: van Straaten
authors.forename: A F M
authors.initials: AF
authors.lastname: Boselie
authors.forename: K
authors.initials: K
authors.lastname: Rijkers
authors.forename: J W
authors.initials: JW
authors.lastname: Weber
authors.forename: J S H
authors.initials: JS
authors.lastname: Vles
mesh_terms: 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