Presentation
Leg weakness.
Patient Data
The MRI sequences demonstrate:
low lying spinal cord terminating at L3-L4 level with a small hydromyelia
diastematomyelia type I at L1-L2 (hemicords separated by a bony spur)
vertebral abnormalities: butterfly vertebrae and block vertebrae from T11 to L2 level
spina bifida at several levels with no meningocele or myelomeningocele
dural ectasia at the lumbar region
Case Discussion
MRI features of diastematomyelia, also known as a split cord malformation type I which is the classic type and characterized by:
duplicated dural sac with midline spur (osseous or osteocartilaginous)
hydromyelia is common
vertebral abnormalities such as hemivertebrae, butterfly vertebrae, spina bifida
cutaneous pigmentation, hypertrichosis, hemangioma are common
patients are usually symptomatic presenting with scoliosis and tethered cord syndrome