Abstract
Hemimyeloschisis is a very rare congenital malformation of the spine which is characterized by a split cord malformation associated with complete exposureof the one hemicord to the exterior. We report a case of hemimyeloschisis on the right hemicord in a patient with hydrocephalus. The patient was a female neonate with myeloschisis, skin defect, and hypertrichosis visible at birth in the upper lumbar region. There was also skin defect around the myeloschisis. Computed tomography (CT) revealed a bony septum at the L2 level as well as the myeloschisis on the right hemicord, which enabled us to make a precise preoperative diagnosis of this rare malformation. There was also mild hydrocephalus in cranial CT scan. Closure of the myeloschisis and removal of the septum were successfully performed associated with the closure of the skin in one stage surgery to prevent subsequent infection and neurological deterioration. Ventriculoperitoneal shunt insertion was performed for hydrocephalus. The presence of combined split cord malformation and myeloschisis is consistent with the hypothesis of an ontogenic basis of development. This combination also emphasizes the importance of early imaging for diagnosis in this complex malformation.
Similar content being viewed by others
References
Abuzayed B, Erdincler P (2014) Aplasia cutis congenita associated with type I split cord malformation: unusual case. J Pediatr Neurosci 9(1):27–29
Akay KM, Izci Y, Baysefer A, Timurkaynak E (2004) Split cord malformation in adults. Neurosurg Rev 27(2):99–105
Akiyama K, Nishiyama K, Yoshimura J, Mori H, Fujii Y (2007) A case of split cord malformation associated with myeloschisis. Childs Nerv Syst 23:577–580
Izci Y, Gonul M, Secer HI, Gonul E (2007) Aplasia cutis congenita: a rare cutaneous sign of split cord malformations. Int J Dermatol 46(10):1031–1035
Izci Y, Gonul M, Gonul E (2007) The diagnostic value of skin lesions in split cord malformations. J Clin Neurosci 14(9):860–863
Merrow AC, Guion CJ (2010) Hemimyelomeningocele. Pediatr Radiol 40(Suppl 1):S168
Pang D (1992) Split cord malformation: part II: clinical syndrome. Neurosurgery 31:481–500
Pang D, Dias MS, Ahab-Barmada M (1992) Split cord malformation: part I: a unified theory of embryogenesis for double spinal cord malformations. Neurosurgery 31:451–480
Pang D, Zovickian J, Oviedo A, Moes GS (2010) Limited dorsal myeloschisis: a distinctive clinicopathological entity. Neurosurgery 67(6):1555–1579 discussion 1579-80
Pantanowitz L, Sur M (2003) Malformations associated with spina bifida. Internet J Pediatr Neonatol 4(1):1–6
Tortori-Donati P, Rossi A, Biancheri R, Cama A (2001) Magnetic resonance imaging of spinal dysraphism. Top Magn Reson Imaging 12(6):375–409
Yamanaka T, Hashimoto N, Sasajima H, Mineura K (2001) A case of diastematomyelia associated with myeloschisis in a hemicord. Pediatr Neurosurg 35:253–256
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
This paper is written in accordance with the ethical standards and there is no conflict of interest.
Rights and permissions
About this article
Cite this article
Izci, Y. Hemimyeloschisis associated with hydrocephalus. Childs Nerv Syst 32, 1145–1148 (2016). https://doi.org/10.1007/s00381-015-2970-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-015-2970-5