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Clinical Medical
Image Library
ISSN: 2474-3682
IMAGE ARTICLE | VOLUME 3, ISSUE 2 | OPEN ACCESS DOI: 10.23937/2474-3682/1510067

Diastematomyelia Type 1 with Multiple Spinal Cord and Vertebral Abnormalities in a Child

Serdar Arslan, Hasan Erdogan , Muhsin Nuh Aybay, Ender Alkan, Arzu Cengiz and Mehmet Sedat Durmaz

Department of Radiology, University of Health Sciences, Turkey

*Corresponding author: Hasan Erdogan, MD, Specialist, Department of Radiology, Konya Education and Research Hospital, University of Health Sciences, 42090, Meram, Konya, Turkey, Tel: +90-506-473-0225, E-mail: dr.hasanerdogan@gmail.com

Received: March 29, 2017 | Accepted: June 12, 2017 | Published: June 14, 2017

Citation: Arslan S, Erdogan H, Aybay MN, Alkan E, Cengiz A, et al. (2017) Diastematomyelia Type 1 with Multiple Spinal Cord and Vertebral Abnormalities in a Child. Clin Med Img Lib 3:067. doi.org/10.23937/2474-3682/1510067

Copyright: © 2017 Arslan S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords


Diastematomyelia, Spinal cord, Vertebrae, Magnetic resonance imaging

A 7-year-old male was brought with a marked spinal deformity. Physical examination showed rotational scoliosis and loss of lumbar lordosis. The patient was referred for a Magnetic Resonance Imaging (MRI) of the lumbosacral spine. MRI showed a left-convex rotational scoliosis and loss of lumbar lordosis. There was a fusion of T10-T11-T12 vertebral bodies with a partial excision (Figure 1). Spinal canal was widening at the level L2-L4. The terminal cone was reaching L5 level. At the level of T10 spine, the spinal cord was divided into two hemicords and two dural tubes up to the upper part of the L3 body. There was a bone septum, dividing the spinal canal into two separate canals including two hemicords in separate dural tubes (Figure 2).

Diastematomyelia is a rare congenital abnormality of the spinal cord in which a part of the spinal cord is split in the sagittal plane into two hemicords [1]. It is more common in women (between 80 to 90%) and usually appears within the thoracolumbar spine (85%) [2]. Two hemicords, each covered by an intact layer of pia arachnoid, travel through a single subarachnoid space surrounded by a single dural sac in nearly 60% of patients with diastematomyelia [1,2]. Among 40% of patients, a bony spur or a fibrous band passing through the two hemicords is encountered [2]. This rare congenital malformation of the spinal cord, which belongs to the group of occult spinal dysraphisms. It may coexist with other spinal dysraphisms, such as myelomeningocele, meningocele, spinal lipoma, neuroenteric cysts or dermal sinuses and vertebral abnormalities, such as hemivertebrae, butterfly vertebrae or scoliosis [3]. Prior to the universal availability of MRI scan, myelography and CT were used to add a new dimension to the diagnosis of dysraphic lesions of the spine [1,3].

Source of Support


None.

Conflict of Interest


None.

 


Figure 1: Coronal T2-weighted (a) and sagittal T2-weighted (b) MR images show left-convex rotational scoliosis and fusion of T10-T11-T12 vertebral bodies with a partial excision (arrow).


Figure 2: Axial T2-weighted (a) and sagittal T2-weighted (b) MR images show a bone septum, dividing the spinal canal into two separate canals including two hemicords in separate dural tubes and the terminal cone reaches the L5 level (arrows).

References


  1. Dorobisz U, Bladowska J, Biel A, Palka L, Hołownia D (2010) MRI diagnosis of diastematomyelia in a 78-year-old woman: Case report and literature review. Pol J Radiol 75: 82-87.

  2. Kachewar S, Sankaye SB (2014) Diastematomyelia-A Report of Two Cases. J Clin Diagn Res 8: 01-02.

  3. Balaji MD, Shivaprakash NC, Prashanth KT (2016) Case of congenital diastematomyelia type 1: A rare presentation. Int J Contemp Pediatr 3: 273-276.