Learning objectives
Lipomyelomeningocele is a form of closed Spinal Dysraphism
The clinical presentation is wide and varies from asymptomatic to complex neurological symptoms below the affected spinal cord level.
There is a poor correlation between the patient symptoms and the findings on MR
Unfortunately currently there is no radiological classification system that allows to asses the severity of the lesion before surgery
We aim to illustrate the clinicoradiological dissociation in lipomyelomeningocoeles and the need for a radiological classification.
Background
These lesions are often diagnosed at childbirth or in young children because of the associated midline deformity,
but it is not uncommon to find adults with an undiagnosed spinal dysraphism which only comes to be clinically apparent when the patient presents with some form of neurological deficit.
They are thought to arise from the accidental entrapment of mesenchymal cells in the midline,
but it is now known that this is an oversimplification of the embryological development of the disease since the lipomatous portion often contains...
Findings and procedure details
We reviewed the radiological,
and clinical data from 40 patients diagnosed with lipomyelomeningocoele,
who were followed up and mostly treated by the department of neurosurgery in our institution.
6 of these were excluded from the study because the medical notes and radiological imaging studies were not available to us which reduced the overall number of analyzed cases to 34.
The MRI protocol we used comprised; sagital (T1,
T2,
Stir),
coronal (T1) an axial (T1,
T2) sequences.
For the 34 patients for whom MRI reports were...
Conclusion
The spectrum of neurological affectation in lipomyelomeningoceles is wide.
As we have highlighted in our study there is no correlation between MRI findings (namely the lipomas size and anatomical location) and the patient's clinical presentation.
This demonstrates that there is need for the development for a radiological classification that would allow to better plan the timing ,the kind of surgical procedure and the patient's prognosis.
We suggest that further investigation is required into the progression of this pathology,
in order to determine what features on...
References
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Christina E.,
B.S,
Krystal L.
Tomei,
M.D,
Peter W.
Carmel,
M.D,
and Chirag D.
Gandhi,
M.D.
"Lipomyelomeningocele: Pathology,
Treatment,
and Outcomes." Medscape.
Accessed December 09,
2016.
http://www.medscape.com/viewarticle/772263_4.
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McLonc DG,
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