Service de Médecine Physique et Réadaptation, Centre Hospitalier Régional Universitaire Brest, Hôpital Morvan, Brest, France.
Pediatr Neurol. 2011 Mar;44(3):229-32. doi: 10.1016/j.pediatrneurol.2010.10.017.
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.
先天性皮窦源于神经管发育异常，较为少见。皮样囊肿感染导致的脊髓髓内脓肿则非常罕见，且功能预后通常较差。我们报告了一例 16 月龄儿童，因皮窦相关皮样囊肿感染导致脊髓髓内脓肿，出现四肢瘫痪。脓肿引流后，切除了皮样囊肿。神经外科手术后，给予抗生素治疗 6 周。患儿在儿科康复科接受随访。1 年后，他能够快速行走，上肢运动功能恢复到与其年龄相适应的水平。然而，膀胱括约肌协同失调仍然存在，需要间歇性导尿。本例强调了早期诊断、手术干预和延长抗生素治疗的重要性。多学科团队的长期随访有助于有效管理相关神经、骨科和膀胱疾病。
