Presentation
Neck pain.
Patient Data
The cervical cord appears split from the level of the medulla to the level of C4 vertebrae into two hemicords, impressive of diastematomyelia.
Vertebral fusion of C2, C3, and C4 vertebrae, suggestive of Klippel Feil syndrome.
MRI exam of the thoracic and lumbar spine revealed normal MRI appearance of the vertebrae and the cord.
CT scan showed vertebral fusion of C2, C3, and C4 vertebrae, suggestive of Klippel Feil syndrome. Also fusion of their posterior neural elements and split spinous processes.
Case Discussion
The case shows the cervical cord split into two hemicords (diastematomyelia) with multilevel vertebral fusion (Klippel-Feil syndrome).
Cervical diastematomyelia/split cord malformation is a rare congenital abnormality.
Diastematomyelia is a congenital abnormality in which the spinal cord is longitudinally divided. It commonly occurs in the thoracic or lumbar regions. It rarely occurs in the cervical spine.
Diastematomyelia is often found in association with other congenital abnormalities, in conjunction with the Klippel-Feil syndrome and Chiari type II malformations.
Diastematomyelia could be either a true duplication of the spinal cord, with each cord surrounded by separate dural sheaths or a partial separation of the cord, with or without septum.
This case is courtesy of Dr. Marwa Romaih, MD of Radiodiagnosis.
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