MRI diagnosis of diastematomyelia in a 78-year-old woman: Case report and literature review.

BACKGROUND

Diastematomyelia is a rare congenital malformation of the spinal cord, which belongs to the group of occult spinal dysraphisms. This disorder consists in the separation of the spinal cord into two parts in the sagittal plane (hemicords). Diastematomyelia may coexist with other spinal dysraphisms, such as myelomeningocele, meningocele, spinal lipoma, neuroenteric cysts or dermal sinuses and vertebral abnormalities, such as hemivertebrae, butterfly vertebrae or scoliosis.

CASE REPORT: We reported a case of a woman with a congenital defect of the spinal cord, in the form of diastematomyelia, which was diagnosed at the age of 78. The patient had been complaining of back pain for many years. The X-ray radiograms showed the fusion of vertebra L3-L4, defective fusion of posterior spinal bony elements L5-S1. Moreover, abnormal hair growth (hypertrichosis) in the lumbar region was found. The separation of the spinal cord was only diagnosed in MR imaging which was performed at the age of 78.

CONCLUSIONS

Diastematomyelia is mostly diagnosed in the prenatal period or in children; much less often in adults. This disorder has to be taken into account in differential diagnosis in patients with X-rays revealing defects of the spine in the form of hemivertebrae, butterfly vertebrae or the fusion of vertebrae, especially when there are additional skin lesions in the back area, at the level of the diagnosed osseous anomalies.