The Experts below are selected from a list of 114 Experts worldwide ranked by ideXlab platform
Ashok Kumar Mahapatra - One of the best experts on this subject based on the ideXlab platform.
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An unusual case of split cord malformation with simultaneous ventral and dorsal bony spur at a single site: A Technical Challenge
Journal of pediatric neurosciences, 2018Co-Authors: Ashutosh Agarwal, Amol Raheja, Sachin A Borkar, Ashok Kumar MahapatraAbstract:Split cord malformation (SCM) with simultaneous ventral and dorsal bony spur at a single site is an extremely rare entity with only one other case reported so far. We present a second such case in a 13-month-old female child, who presented with a Skin Dimple over the lumbar region with overlying hairy patch without any associated lower limb weakness or urinary complaints. Imaging demonstrated a complex Type I SCM with simultaneous ventral and dorsal bony spur at L4-L5 level. Intraoperatively, the patient was confirmed to have a Type Ic SCM with a ventrally based bony spur going dorsally to attach on the hypertrophied posterior arch of L4 and a dorsal spur going ventrally to attach on the L4 vertebral body. After meticulous microsurgical excision of the spur, the child was stable and developed no fresh neurological deficits. We discuss the relevant surgical implications and possible embryological mechanisms involved in such a complex SCM.
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Terminal myelocystoceles: a series of 17 cases.
Journal of Neurosurgery: Pediatrics, 2005Co-Authors: Deepak Gupta, Ashok Kumar MahapatraAbstract:Object A terminal myelocystocele is a rare form of spinal dysraphism in which the hydromyelic caudal spinal cord and the subarachnoid space are herniated through a posterior spina bifida. In their study of 17 cases, the authors attempt to develop treatment guidelines for patients suffering from this condition. Methods Seventeen patients (age range 2 months–5 years) underwent surgery during a 7-year period. Surprisingly, nine of 17 patients had no neurological deficits. Among these nine asymptomatic cases, three patients had a dermal sinus and two had a Skin Dimple, whereas one had congenital talipes equinovarus deformity (CTEV). Among the eight patients with neurological deficits, seven had lower-limb weakness (two had complete paraplegia), and one patient had urinary incontinence and constipation. Four patients each had a dermal sinus and CTEV; interestingly, one infant had an accessory phallus. Radiologically, eight patients had pure myelocystoceles, and a diagnosis of lipomyelocystocele was made in nin...
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Terminal myelocystoceles: a series of 17 cases.
Journal of neurosurgery, 2005Co-Authors: Deepak Kumar Gupta, Ashok Kumar MahapatraAbstract:A terminal myelocystocele is a rare form of spinal dysraphism in which the hydromyelic caudal spinal cord and the subarachnoid space are herniated through a posterior spina bifida. In their study of 17 cases, the authors attempt to develop treatment guidelines for patients suffering from this condition. Seventeen patients (age range 2 months-5 years) underwent surgery during a 7-year period. Surprisingly, nine of 17 patients had no neurological deficits. Among these nine asymptomatic cases, three patients had a dermal sinus and two had a Skin Dimple, whereas one had congenital talipes equinovarus deformity (CTEV). Among the eight patients with neurological deficits, seven had lower-limb weakness (two had complete paraplegia), and one patient had urinary incontinence and constipation. Four patients each had a dermal sinus and CTEV; interestingly, one infant had an accessory phallus. Radiologically, eight patients had pure myelocystoceles, and a diagnosis of lipomyelocystocele was made in nine instances on the basis of magnetic resonance images. All patients underwent surgery. The meningocele sacs were excised, and the bands tethering the myelocystocele sac to the meningocele sacs were incised, with as little damage to the roots as possible. Two patients experienced postoperative CSF leakage (one required reexploration), and two others had subcutaneous CSF collection. No patient had deterioration of the neurological condition after surgery. The authors present the largest study of patients with terminal myelocystocele to date and emphasize that the possibility of this condition must be kept in mind when addressing all congenital lumbosacral masses. The authors assert that myelocystoceles and lipomyelocystoceles should be kept in the same category and recommend early surgery in all cases.
R. A. Minns - One of the best experts on this subject based on the ideXlab platform.
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Cervical cord tethering due to split cord malformation at the cervico-dorsal junction presenting with self-mutilation of the fingers
Developmental medicine and child neurology, 2002Co-Authors: L. M. Myles, A J W Steers, R. A. MinnsAbstract:An unusual case of cervical spinal cord tethering with diplomyelia is described. A 12-month old female presented with self-mutilation of the fingers due to sensory loss in the hands, absent reflexes, poor muscle tone, and reduced distal upper-limb movements. There was a deep Skin Dimple overlying the T1 spinous process. Imaging showed angulation of the lower cervical cord and an operation revealed a low cervical meningocele and a split cord malformation with tethering of one half of the cord; the cord was untethered. In this report the literature is reviewed.
T. Y. Lin - One of the best experts on this subject based on the ideXlab platform.
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Dermal sinus with dermoid cyst in the upper cervical spine: case note.
Neuroradiology, 2000Co-Authors: W. C. Shen, T. L. Chiou, T. Y. LinAbstract:We describe a 5 year-old girl who had a Skin Dimple of the back of her upper neck. MRI showed a dermal sinus tract in the upper cervical spine, associated with an intramedullary dermoid cyst at C 2–3, and spina bifida. A laminectomy was performed, the dermoid cyst and the sinus tract were completely removed. This congenital complex is very rare.
A. Nagano - One of the best experts on this subject based on the ideXlab platform.
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A congenital dermal sinus presenting the muscle fasciculation and hypertrophy
Acta Neurologica Scandinavica, 2001Co-Authors: M. Takahashi, H. Murata, T. Ohmura, A. NaganoAbstract:Objective– To report unique and unknown clinical features of muscle fasciculation and muscle hypertrophy in a case of congenital dermal sinus. Patients– A 16-year-old girl presented with continuous fasciculation, often cramp, and hypertrophy of the left calf muscle. The radiography showed spina bifida of L4, L5 and S1. MRI revealed dermal sinus tract from the Skin Dimple of the back to the dura mater, and connected to the intradural inclusion tumor. At surgery the inclusion tumor contained many short hairs, and the cauda equina were severely adherent. Microdissection of the tumor and the adhesion was performed. At 2 years after surgery fasciculation decreased but continued; however, painful cramps of the calf muscle do not occur. Conclusions– Short hairs of dermoid and the adherence might be irritative to the cauda equina. The hyperactivity of the stimulated motor neuron may cause the muscle fasciculation leading to hypertrophy of the calf muscle.
L. M. Myles - One of the best experts on this subject based on the ideXlab platform.
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Cervical cord tethering due to split cord malformation at the cervico-dorsal junction presenting with self-mutilation of the fingers
Developmental medicine and child neurology, 2002Co-Authors: L. M. Myles, A J W Steers, R. A. MinnsAbstract:An unusual case of cervical spinal cord tethering with diplomyelia is described. A 12-month old female presented with self-mutilation of the fingers due to sensory loss in the hands, absent reflexes, poor muscle tone, and reduced distal upper-limb movements. There was a deep Skin Dimple overlying the T1 spinous process. Imaging showed angulation of the lower cervical cord and an operation revealed a low cervical meningocele and a split cord malformation with tethering of one half of the cord; the cord was untethered. In this report the literature is reviewed.