Spina bifida and encephalocele
Prem Puri in Newborn Surgery, 2017
The term spina bifida occulta refers to spinal dysraphism not accompanied by extrusion of the contents of the vertebral column. Spina bifida occulta, without any external evidence, is rarely diagnosed in the newborn. Occasionally, it may cause neurological deficit because of a tethering of the cord. Some patients may have external evidence of spina bifida occulta, such as a small dimple, sinus, tuft of hair (Figure 96.1), or hamartomatous lesions such as hemangioma, lipoma, or nevi. Neural involvement may manifest as urinary problems, (e.g., recurrent urinary infection or enuresis), motor deficit with pedal deformity, pelvic tilt and muscle weakness, or sensory involvement in the form of trophic ulceration. All these patients warrant careful examination and investigation. Spinal x-ray will show evidence of spina bifida and other spinal abnormalities. Ultrasonography can be useful in the newborn period to diagnose diastomatomyelia.27 The common clinically relevant lesions are lipomyelomeningocele, tethered cord, dermal sinus tract, and diastematomyelia. All of these lesions warrant craniospinal magnetic resonance imaging (MRI) and referral to a neurosurgical specialist. The increased incidence and treatment of these lesions over the last 10–20 years probably reflects more widespread availability of MRI.
Central Nervous System, Head and Neck
Vincent Helyar, Aidan Shaw in The Final FRCR, 2017
This is a midline spinal bone defect with a skin covering (i.e. closed defect) in the lumbosacral region. There may be a dermal sinus, hairy patch or haemangioma above the intergluteal fold. May be incidental. Lipomyelocele—the lipoma/placode interface is inside the spinal canal.Lipomyelomeningocele—lipoma/placode interface is outside the spinal canal.
Developmental Diseases of the Nervous System
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Disorders of primary neurulation: Myelomeningocele.Myeloschisis.Lipomas with dural defects (lipomyelomeningocele and lipomyeloschisis).
Congenital Spinal Lipomatous Malformations. Part 2. Differentiation from Selected Closed Spinal Malformations
Published in Fetal and Pediatric Pathology, 2021
Lumbosacrococcygeal spina bifida occulta develops as a skin-covered (closed) malformation from a combination of genetic, environmental, and perhaps other events that alter the primary or secondary neural tube and surrounding tissue in the embryo. Congenital spinal lipomatous malformations (spinal lipomas, lipomyeloceles, and lipomyelomeningoceles) in the midline of the lower back are relatively infrequently encountered whether they are isolated or, more commonly, part of a closed spina bifida complex. These malformations are the most common forms of closed spina bifida encountered in large clinical practices. Within this malformation group, there is no universally-recognized size distinction, subgroup definition, or histopathologic differentiation. The terms for these fibrofatty masses have been interchangeable. The terms themselves are minimally descriptive and only partially distinctive for site and cellular content. Some classifications require that a lipomyelomeningocele include spinal cord tissue outside the spinal canal; others do not. Meningeal tissue is usually not found [1].
Relationships among classifications of impairment and measures of ambulatory function for children with spina bifida
Published in Disability and Rehabilitation, 2021
Susan A. Rethlefsen, Melissa A. Bent, Nicole M. Mueske, Tishya A. L. Wren
Sixty-one children were included in the current study, 34 males (56%) and 27 females (44%). Average age of participants at enrollment was 9.8 years (standard deviation (SD) 2.7, range 6–15). Forty-seven participants (77%) had myelomeningocele and 14 participants (23%) had lipomyelomeningocele. Thirty-seven participants (61%) had ventriculoperitoneal shunts, 26/37 (70%) of whom had undergone at least 1 revision (range: 1–9 revisions). Sixteen participants (26%) had undergone prior tethered cord release surgery. Twenty-two participants (36%) had undergone previous orthopedic surgery to the lower limbs.
Congenital Spinal Lipomatous Malformations. Part 1. Spinal Lipomas, Lipomyeloceles, and Lipomyelomeningoceles
Published in Fetal and Pediatric Pathology, 2020
The clinical definition of a lipomyelomeningocele often requires spinal cord herniation outside the spinal canal, and this often specifically refers to the neural placode [4, 19, 120, 129]. The same lesion complex, often including subcutaneous tissue that is part of the malformation, but with the spinal cord itself remaining within the spinal canal, is generally called a lipomyelocele.
Related Knowledge Centers
- Anencephaly
- Birth Defect
- Encephalocele
- Gastrulation
- Neural Tube
- Skull
- Vertebral Column
- Brain
- Spina Bifida
- Iniencephaly