Recovery after tetraplegia caused by dermal sinus infection: intramedullary abscess and tetraparesis.

Congenital dermal sinuses result from abnormal neurulation, and are uncommon. A spinal intramedullary abscess secondary to an infected dermoid cyst is very rare, and the functional prognosis is usually quite poor. We report on a 16-month-old child with tetraplegia secondary to intramedullary abscesses because of a dermoid cyst infection associated with a dermal sinus. The abscesses were drained, and the dermoid cyst was removed. Antibiotics were administered for 6 weeks after neurosurgery. The child was followed at a pediatric rehabilitation department. After 1 year, he was able to walk quickly and had regained appropriate upper limb motor function for his age. However, bladder sphincter dyssynergia persisted, requiring intermittent catheterization. This case highlights the importance of early diagnosis for surgical intervention and prolonged antibiotic therapy. Long-term follow-up by a multidisciplinary team allowed for the effective management of related neurologic, orthopedic, and bladder disorders.

Timing of surgery in patients with infected spinal dermal sinuses: report of two cases.

In the past, if infection was present at the time a spinal dermal sinus was discovered, the sinus opening and cerebrospinal fluid were sterilized with a course of appropriate antibiotic therapy prior to the surgical intervention. The cases of two children with an infected spinal dermal sinus are reported here. One patient developed acute paraplegia during the initial stage of antibiotic therapy, and the second patient, who was admitted only with signs of fever and irritability, experienced after antibiotic therapy a complete myelographic blockade secondary to a large infected intradural dermoid tumor. The authors stress the importance of early neuroradiological and neurosurgical management of these lesions, even when an infection is present.