Adult-onset presentation of cervicothoracic split cord malformation: illustrative case

BACKGROUND A 60-year-old female presented with a 6-month history of progressive lower limb pain, weakness, and declining mobility. She was initially diagnosed as having possible hip osteoarthritis or ligamental knee injury. She was eventually seen by a neurologist, who admitted her to a tertiary hospital with new-onset upper motor neuron signs and urinary incontinence. Magnetic resonance imaging of the whole spine revealed evidence of C7–T2 type 1 split cord malformation (SCM) necessitating urgent spinal surgery. She had an excellent outcome with intensive rehabilitation and returned to her premorbid level of function and mobility. OBSERVATIONS The patient presented with nonspecific symptoms, which led to multiple referrals and a significant delay in her diagnosis. LESSONS Clinicians should be aware of the importance of a detailed history with thorough neurological and spinal examinations.

Tetrad of Split Cord Malformation I with Neuroenteric Cyst, Dermoid Cyst, and Thickened Filum Terminale in a 2-Year-Old Child: A Case Report

<b><i>Introduction:</i></b> Split cord malformations (SCMs) are developmental anomalies that are associated with a number of congenital defects. However, a combination of SCM I with a neuroenteric cyst (NEC) is extremely rare, and only 11 cases have been described in the literature. To the best of authors’ knowledge, the combination of the above two with dermoid cyst and thickened filum terminale has never been reported in the literature. <b><i>Case Presentation:</i></b> We present a case of the above combination in a 2-year-old child who underwent microsurgical excision of all 4 pathologies and complete recovery. <b><i>Conclusion:</i></b> NEC and dermoid should be considered in the differential diagnosis when imaging reveals cystic pathology along with SCM. Expeditious surgical repair resulted in an outstanding functional outcome at 1-year follow-up.