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Lippincott Williams & Wilkins, Philadelphia, PA, pp– Sivit CJ, Siegel MJ ( a) Invaginación intestinal. In: Siegel MJ (ed) Ecografía Pediátrica, 2nd edn., . Get this from a library! Ecografía pediátrica. [Marilyn J Siegel]. Libros de Segunda Mano – Ciencias, Manuales y Oficios – Medicina, Farmacia y Salud: Ecografia pediatrica, por siegel en excelente estado. Compra, venta y.

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Occult spinal dysraphism is defined as a group of dysraphic conditions present below an intact cover of dermis and epidermis. The ultrasonographic findings from the spine were 1 discontinuity of the posterior bone layers in the L5 and S1 projections, with an intracanal solid formation presenting undefined margins and a heterogenous hyperrefringent interior, adhering to the distal segment of the medullary cone; 2 a medullary cone extending beyond the L3 body Figure 2.

The magnetic resonance imaging has the capacity to identify the type and the level of lesion. The following abnormalities can be included as forms of occult spinal dysraphism: Sweeps in longitudinal and transverse planes were performed, with the aims of making a detailed assessment of the contiguity of the anatomical features with themedullary canal: Because of the possibility of irreversible sequelae through delayed diagnosis, a screening method for patients at high risk of occult spinal dysraphism becomes necessary [7].

Atendimento ao Aluno 11 Hence, this method is reserved for situations in which abnormal findings are seen, or when the normal maturation of the skeleton limits the possibility of viewing the medullary canal [5]. Ultrasonography is a fast, safe, noninvasive, and low-cost method, and it also presents good correspondence with the findings from magnetic resonance imaging. This produced the following findings: Basedon thephysicalfindings, cases of spinal dysraphism can be grouped into two categories: This case was different from our protocol because the neonate was referenced to realize the transfontanellar ultrasound, and only after the observation of cutaneous stigma, the protocol of occult spinal dysrapism was performed.

In three prospective studies in the literature, the highest incidence reported, in an evaluated population of 2, patients, was 7.

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High-resolution ultrasonography using a linear transducer made it possible to identify and characterize the lesion, and magnetic resonance imaging confirmed the type of lesion lipomyelomeningocele and enabled adequate surgical planning.

Spinal dysraphism is a term used for a group of disorders characterized by incomplete fusion or lack of fusion of midline structures during the fourth week of embryogenesis [1]. Cases of spinal dysraphism are rare, even in newborns with cutaneous stigmas. Ecigrafia is therefore more difficult to diagnose on antenatal ultrasonography. Of these, only 5. Some stigmas have been proven to present greater risk of occult spinal dysraphism, such as deep or atypical sacrococcygeal dimples, hemangiomas, cutaneous aplasia, subcutaneous masses, and exophytic skin lesions such as tails and hair tufts.


Images in B and color Doppler modes were obtained. Magnetic resonance imaging is another diagnostic imaging method for evaluating cases of occult spinal dysraphism.

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Transfontanellar ultrasonography did not show any abnormalities. We believe that ultrasonography should be performed on patients who are at high risk of occult spinal dysraphism, such as those presenting cutaneous stigmas, congenital abnormalities, or neurological alterations, as ameans of early diagnosis, thereby avoiding neuropsychomotor sequelae later on.

The incidence of these defects siefel significant geographical variation from eecografia. In summary, we have presented a case of a neonate with occult spinal dysraphism associated with cutaneous stigmas.

Early diagnosis of spinal dysraphism is very important in order to minimize the epdiatrica that occur in patients who are not diagnosed before the growth spurt, who may suffer neural disorders due to medullary ischemia. The neonate underwent corrective surgery and, over a six-month followup, presented normal neuropsychomotor development.

A neurological examination done earlier had not shown any abnormalities. Indique a um amigo Imprimir.

CASE REPORT A five-day-old white female neonate was sent to our service for transfontanellar ultrasonography to be performed, because of the presence of cutaneous ecogtafia in the lumbar region. Magnetic resonance imaging should be reserved for patients with positive or inconclusive results from ultrasonography, for confirmation of the diagnosis and surgical planning, as reported in the present case, in which the ultrasonographic findings were fully confirmed by the magnetic resonance imaging.

Atendimento ao Aluno 11 Agendamento de exames 11 A ultrassonografia tem sido utilizada para avaliar o canal medular desde [2]. In our service, the protocol to neonates with high risk of occult spinal dysraphism with cutaneous stigma is accomplishment of spinal ultrasound using the linear transductor.

In this abnormality, the spinal cord is lowand anchored by the lipoma [2]. High-resolution ultrasonography is a fast and accurate method for screening for occult dysraphic lesions.

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The echographic findings suggestive of occult spinal dysraphism include a low position for the medullary cone, bulbous medullary cone, thick filum terminale, dorsal attachment of the spinal cord, and loss of cardiorespiratory pulsatory movement of the spinal cord [8]. The diagnostic hypothesis was that a defect of the medullary canal was present in the region of the cutaneous stigma, with anchored spinal cord and an intracanal solid medullary formation with apparent peripheral invasion that was continuous with the spinal cord, suggestive of a lipoma.


The protocol to neonates with high risk of occult spinal dysraphism has demonstrated good results; however, the physicians should be aware of neonates with cutaneous stigma because of high incidence of occult spinal dysraphism.

Physical examination on the newborn showed a skin appendage resembling a tail, on the midline in the lumbosacral region. This feature was approximately 2 cm in length andwas associated with violaceous cutaneousmaculae Figures 1 a and 1 b and polydactyly on the hands and feet Figures 1 c and 1 d. Early diagnosing of occult spinal dysraphism prevents progressive neurological dysfunction. Theultrasound has great capacity to assess the vertebral canal.

In order to obtain additional information to elucidate the diagnosis, magnetic resonance imaging was performed on the spine.

A five-day-old white female neonate was sent to our service for transfontanellar ultrasonography to be performed, because of the presence of cutaneous stigmas in the lumbar region. Ultrassonografia Geral Relato de Caso: The magnetic sieel findings were compatible with lipomyelomeningocele, and the neonate was referred to a tertiary-level pediatric neurosurgery service.

Echography is considered to ecografua an effective low-cost noninvasivemethod and plays a critical role in diagnosing or ruling out occult spinal dysraphism at birth [2]. Agendamento de exames 11 Baixe o PDF deste artigo. Ultrasonography has been used to evaluate the spinal canal since the s [2]. In our case, the neonate presented exophytic skin lesions in the lumbar region and hands postaxial polydactyly.

It may be suspected in asymptomatic newborns because it is generally associated with abnormalities of the adjacent skin, such as cutaneous stigmas, hemangiomas, hair tufts, cutaneous appendices, sacrococcygeal dimples, and pwdiatrica masses, particularly in the lumbosacral region [4].

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In T1 and T2 views, this technology enables detailed evaluation of the skin, medullary, canal and intervertebral discs, thus making adequate planning for corrective surgery possible [6]. Cases of multiple stigmas comprise another group at risk [7]. Here, we present a case of a five-day-old neonate with occult dysraphism of lipomyelomeningocele type who presented cutaneous stigmas, and we demonstrate the main ultrasonographic and magnetic resonance findings from the spine. However, detecting this condition in neonates is difficult since the neurological signs in these patients are not apparent.