Dorsal Spinal Intradural Intramedullary Epidermoid Cyst: A Rare Case Report and Review of Literature

Epidermoid cysts are commonly seen intracranial lesions but their occurrence in the spine is rare. They account for <1% of all the benign tumors of the spine. These are benign epithelial-lined cysts filled with keratin. They are classified into two types: congenital or acquired. Congenital epidermoid cysts are more commonly associated with spinal dysraphic states such as syringomyelia, dermal sinus and spina bifida whereas the acquired cysts are associated with repeated lumbar punctures. Based on the location, they can be extradural, intradural, extramedullary, or intramedullary. Most of the epidermoids are intradural extramedullary. Intramedullary epidermoid cysts are very uncommon. We report a case of a 6-year-old female patient with dorsal epidermoid cyst with neurological deficits. Magnetic resonance imaging of the spine showed a well-defined lesion from D9 to D12 which was hypointense on T1W1 and heterogeneously hyperintense on T2W2. Surgery was performed to excise the lesion and to decompress the spinal cord. Histopathological examination of the excised lesion confirmed it as an epidermoid cyst

A Study of Traumatic Cord Contusions - Management and Outcomes

Background: There is convincing preclinical evidence that early decompression in the setting of spinal cord injury (SCI) improves neurologic outcomes. However, the effect of early surgical decompression in patients with acute SCI remains uncertain. Aims: To study the long-term outcomes of patients presenting with spinal cord contusions and to compare the neurological outcomes in patients who underwent surgery and those who were managed conservatively. Materials and methods: A prospective study was conducted on all patients admitted with features of cord contusions and central cord syndrome for 2 years. Information gathered included mechanism of injury, previous neurological status, length of hospital stay and functional status. Group 1 included patients younger than 50 years of age, Group 2 included from 50 to 70 years of age and Group 3 had patients who were above 70 years of age. Results: Out of the 147 patients only 26 patients had a single level involvement. Around 61.6% of study subjects with injury of spinal cord at &gt;2 levels were found to have good outcome. Almost 54.5% of study subjects had good outcome in which spinal cord injury was at 2 levels and 34.6% of study subjects had good outcome among whom spinal cord injury was at 1 level only. The difference was found to be significant statistically. Patients undergoing early surgical intervention have better outcomes. Conclusion: It is concluded that Surgery is a better mode of management for cervical cord contusions