Presentation
The present study aimed to identify prognostic factors for continence and need for CIC in LMM. STUDY DESIGN: The present study retrospectively identified 143 patients from the multidisciplinary clinic who underwent TCR for LMM between 1995 and 2010. [ncbi.nlm.nih.gov]
Entire Body System
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Gangrene
An emergent laparotomy was performed and revealed diffuse gangrenous change of both small and large bowels. A jejunostomy was done and strong antibiotics were given, but the baby died two days after the operation. [ncbi.nlm.nih.gov]
Gastrointestinal
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Abdominal Distension
The clinical presentations were bloody stool and abdominal distension. A plain abdominal film demonstrated pneumatosis intestinalis and air in the portal vein. [ncbi.nlm.nih.gov]
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Abdominal Mass
The lipomyelomeningocele presented as an expanding abdominal mass. Ventriculoatrial shunting and two operations to repair the myelomeningocele were performed to control the expanding abdominal mass. [ncbi.nlm.nih.gov]
Skin
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Cutaneous Manifestation
Patients frequently present with cutaneous manifestations, progressive neurological deterioration, bladder dysfunction, and intractable pain. Early surgical intervention with untethering is recommended for symptomatic patients. [ncbi.nlm.nih.gov]
Manifestations Found in Patients with Lipomyelomeningocele SERIES HOFFMAN ET AL., 20 1985 ( N 97) KANEV ET AL., 22 1990 ( N 80) Soft tissue mass 97 80 Skin dimple 26 14 Hemangioma 24 9 Hypertrichosis 1 11 Skin tag/tail-like appendage 5 6 Atretic or denuded [clinicalgate.com]
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Subcutaneous Mass
The scan indicated an echoic semisolid subcutaneous mass covered by skin, posterior to the lumbosacral spinal canal of the fetus. [ncbi.nlm.nih.gov]
RESULTS The scan indicated an echoic semisolid subcutaneous mass covered by skin, posterior to the lumbosacral spinal canal of the fetus. Based… CONTINUE READING [semanticscholar.org]
Slightly more than one third of patients will demonstrate an asymmetrical subcutaneous mass with regard to the midline; these patients have a higher incidence of neurological deficits in the lower limb ipsilateral to the side of the mass. 25 Symptoms [clinicalgate.com]
Note the subcutaneous mass and fascial penetration of the fatty tissue that has tethered the cord distally within the spinal canal. [neupsykey.com]
Musculoskeletal
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Muscular Atrophy
Clinical examination may reveal muscular atrophy, leg length discrepancy, varus or valgus foot deformity of one or both legs, hammertoes or claw toes, scoliosis, mixed deep tendon reflexes (absent, normal, increased), mixed/patchy sensory abnormalities [clinicalgate.com]
Neurologic
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Motor Disturbances
RESULTS: Preoperatively, all patients displayed severe neurological deficits such as motor disturbance, muscle atrophy, and bladder dysfunction. Several months before surgery, all showed progressive symptoms. [ncbi.nlm.nih.gov]
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Lower Motor Neurone Lesion
One child had a lower motor neuron lesion, and 5 had a mixed upper and lower motor neuron lesion. [ncbi.nlm.nih.gov]
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Limb Weakness
Out of these nine patients, three patients with lower limb weakness associated with urinary and fecal incontinence showed improvement in both motor and bladder/bowel functions and regained bladder/bowel control. [ncbi.nlm.nih.gov]
Workup
Neuroimaging Magnetic resonance imaging (MRI) evaluation was carried out as part of diagnostic workup in all patients. Low lying tethered cord was present in all the patients. [ncbi.nlm.nih.gov]
Treatment
Spine-shortening osteotomy might be a feasible mode of treatment for adult TCS caused by a spinal lipoma. [ncbi.nlm.nih.gov]
Simple cosmetic treatment does not prevent neurologic difficulties and may make later, more complete treatment difficult. [neurosurgery.ucla.edu]
Simple cosmetic treatment of the subcutaneous fat pad does NOT prevent Neurological deficit, and may make later definitive treatment more difficult. [lexilouandus.blogspot.com]
and treatment strategies for traumatic brain injury in soldiers. [books.google.com]
Prognosis
Prognosis for the infant with this skin-covered lesion is very good if appropriate care is provided early. [ncbi.nlm.nih.gov]
Prognosis - Lipomyelomeningocele hey are classified as dorsal, caudal and transitional varieties. Lipomas of the filum terminal form a different category. [checkorphan.org]
The early diagnosis and the operative treatment may improve the outcome and the prognosis for the patient. Keywords lipomyelomeningocele; tethered cord effect; operative technique; results [thieme-connect.com]
This case illustrates the favorable prognosis of this entity and the importance of prompt diagnosis and multidisciplinary counseling 6). References [operativeneurosurgery.com]
Etiology
Although a genetic component has been well established in the etiology of open NTDs, studies examining the genetics of closed NTDs such as lipomyelomeningocele are rare. [ncbi.nlm.nih.gov]
Open NTDs have a complex etiology, involving both genetic and environmental factors. [nature.com]
This can be caused by a variety of etiologies: myelomeningocele, lipomyelomeningocele, diastematomyelia, tight filum terminale, dermal sinus tract, tumor, and scar tissue. [medical-dictionary.thefreedictionary.com]
Epidemiology
BACKGROUND: The epidemiology of neural tube defects (NTDs) may depend on the type of the defect and its location. There is little epidemiologic information on lipomyelomeningocele, a type of NTD. [ncbi.nlm.nih.gov]
Epidemiology and control of neural tube defects. Oxford, UK: Oxford University Press ; 1992. 12. George TM, Wolpert CM, Worley G, Mackey JF, Fuchs HE, Speer MC. Variable presentation of Neural Tube Defects in Three Families. [nature.com]
Pathophysiology
The current pathophysiological theories and surgical management are discussed. [ncbi.nlm.nih.gov]
Pathophysiologically, neuronal dysfunction in tethered cord syndrome results partly from inability for the spinal cord neurons to utilize oxygen, that is, the impaired oxidative metabolism, partly due to lack of oxygen supply (ischemic effect), and partly [rarediseases.org]
Prevention
This new surgical procedure can maintain a CSF bath around the lumbosacral cord, thus preventing dural adhesion. [ncbi.nlm.nih.gov]