Pediatric Radiology

, Volume 40, Supplement 1, pp 168–168

Hemimyelomeningocele

Authors

    • Department of Pediatric RadiologyChildren’s Hospital of Alabama
  • Christopher J. Guion
    • Department of Pediatric RadiologyChildren’s Hospital of Alabama
Clinical Image

DOI: 10.1007/s00247-010-1734-3

Cite this article as:
Merrow, A.C. & Guion, C.J. Pediatr Radiol (2010) 40: 168. doi:10.1007/s00247-010-1734-3
A 17-month-old international adoptee presented to a neurosurgery clinic with a membrane-covered sac emanating from a lower thoracic spinal defect. The child had normal function of the right lower extremity and minimal movement of the left lower extremity with a left clubfoot. The asymmetry of findings suggested an underlying split- cord malformation, which was confirmed by spinal MRI (Fig. 1) and CT (Fig. 2). These scans showed a right hemicord (white arrow) separated by a bony spur (dashed arrow) from the left hemicord myelomeningocele (asterisk). Brain MRI showed typical Chiari II features.
https://static-content.springer.com/image/art%3A10.1007%2Fs00247-010-1734-3/MediaObjects/247_2010_1734_Fig1_HTML.gif
Fig. 1

Axial fat-suppressed T2-W image

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-010-1734-3/MediaObjects/247_2010_1734_Fig2_HTML.gif
Fig. 2

Axial low-dose CT image

The split-cord malformation (or diastematomyelia) represents a sagittal cleft of the spinal cord into two hemicords that can be enclosed in single or separate dural sheaths and separated by a fibrous or osteocartilaginous septum, respectively [1]. Up to 85% have associated spinal anomalies, the most common being low-lying conus medullaris and thickened filum terminale [1]. A myelomeningocele involving one of the hemicords (i.e. hemimyelomeningocele) is seen in up to 41% of cases [2].

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© Springer-Verlag 2010