Neurological approaches treating rare congenital defects

Neurological approaches treating rare congenital defects

Lucknow: Apollomedics Super Specialty Hospital conducted excision and repair of a large cystic swelling on head along with spina bifida surgery successfully. Split cord malformation (SCM) is a rare congenital spinal abnormality. Occipital cysts are formed generally when a few cells get trapped when the brain and spinal cord form before birth.

One such case was a Santoshi Devi’s 3 days old child, full term normal delivery with a cystic swelling on the back of head since birth and abnormal curvature in thoracic spine. MRI Spine showed spinal cord divided into two segments known as hemicords (Split cord Malformation type 1) with a bony septum at D8/9 level dividing the spinal cord between the two hemicords. Cranial MRI showed two large sacs of brain covering called duramater which were protruding fron the back of head known as Occipital encephalocele. This was accompanied with herniation of brain (occipital lobe and cerebellum) into the sac cavity with obstruction of major venous channel of brain i.e. Rt transverse sinus.

Apollomedics Super Specialty Hospitals, Senior Consultant Neurosurgeon Dr. Sunil Kumar Singh said that, ”Patient was taken up for early surgery and two surgeries were performed in the same setting; first was excision and repair of occipital encephalocele, the sacs were separated from the surrounding tissues and were excised and repair of the defect in brain coverings as well as skull defect repair was done. D8-9 laminectomy with excision of bony septum with Dural reconstruction and cord detethering. The bony septum dividing the spinal cord into two hemicords was excised. Also a dermoid compressing spinal cord was excised. The coverings of spinal cord (duramater) was repaired and reconstructed into single dural canal.

The Child is showing good recovery with no neurological deficits taking feeds orally, he added.”

Dr. Prarthna saxena Associate consultant Neurosurgeon, Apollomedics Super Specialty Hospital told that, “The patients with SCM, when they grow up, symptoms of tethered cord, include leg weakness, low back pain, scoliosis, incontinence make an individual dependent for life. For us, the surgical procedure was mandatory. In case a surgical correction of a spinal deformity is needed, we recommend a two-stage surgery.

Dr. Mayank Somani Managing Director and CEO, Apollomedics super speciality hospital said that “we have a brilliant doctors here at Apollomedics hospital. I congratulate to Dr. Sunil Kumar Singh and Dr. Prarthna saxena for this successful surgery, we are well equipped with all the advanced life saving medical equipment and technology to treating rare congenital defects.”

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