Spinal cord lipoma without dysraphism in the infancy that extends intracranially. Case report and review of the literature.

BACKGROUND: Spinal intramedullary lipoma extending to the posterior fossa is very rare in children. We made a revision of the literature and report the diverse opinions and surgical procedures. CASE DESCRIPTION: We report the case of a 16-month-old male infant who was operated on in the Pediatric Neurosurgical Unit of our hospital; his clinical and surgical outcome are related. CONCLUSION: Intramedullary lipoma of the spinal cord with intracranial extension in infancy is a very rare pathology reported in the literature. Our patient was treated with decompression and subtotal removal; he had a critical postoperative course but was recovering slowly after that. Most authors prefer incomplete resection because these lesions do not have a clear-cut margin. Another neurosurgeon performed a decompression only, without resection. Some authors performed the surgical treatment before symptom progression. Another surgeon reported that the surgical indication is debatable when the neurologic manifestations are poor or absent. The surgical indication and the strategy for treatment are controversial and they depend on the clinical situations of the patients.

Birth trauma and development of growing fracture after coronal suture disruption.

INTRODUCTION: A growing fracture is a rare complication of skull fractures characterized by progressive diastatic enlargement of the fracture line. Growing skull fractures related to birth trauma were only occasionally reported. As far as we know, only one previous case of a neonatal growing fracture secondary to coronal suture disruption has been reported. CASE REPORT: We present the case of a full-term infant born after a nontraumatic, forceps-assisted spontaneous delivery, who developed an increasing cystic swelling over the left frontoparietal area that crossed over coronal and sagittal sutures. The lesion was initially misinterpreted as cephalhematoma. Clinical and radiological follow-up established the correct diagnosis of leptomeningeal cyst. OUTCOME: The collection was initially tapped. Surgical treatment was undertaken thereafter, consisting of decompression and resection of the cyst and dural repair. Two months after follow-up, the patient remains asymptomatic and the porencephalic cavity remains isolated from the extradural space, with no evidence of new fluid collections.

Influence of the type of operations on the development of latex sensitization in children with myelomeningocele.

BACKGROUND: A genetic tendency to develop latex IgE responses in children with spina bifida has been suggested, but their degree of exposure to latex as well as the route and chronology for sensitization can be different from those of other children with multiple surgeries. The aim was to study the influence of the type of operation on the development of latex sensitization in children with myelomeningocele. METHODS: In 90 children with myelomeningocele operated with latex, data were collected about age, sex, family, and personal history of allergy, serum total IgE, presence of a ventricular-peritoneal (v-p) shunt, and number and duration of operations, classified as urological, orthopedic, on the v-p shunt, other neurosurgical, and others. A multivariate logistic regression analysis was performed, using the presence of latex sensitization as dependent variable. RESULTS: Serum total IgE, the number of urological and of orthopedic operations were synergistic variables to predict latex sensitization, together with the presence of a v-p shunt, but not the number of operations performed on this device. This seems to play an adjuvant role in the process of sensitization. CONCLUSIONS: Not only the number, but also the type of operations, namely, of urological and orthopedic nature, is important in the development of latex sensitization in children with myelomeningocele.