Dorsal dermal sinus
 Discussion of Dorsal dermal sinus
- A dorsal dermal sinus is an epithelium-lined tract from the skin to the spinal cord, cauda equina, or arachnoid.
- Predominantly located in the lumbosacral region and less often in the occipital region.
- Dorsal dermal sinus is caused by incomplete separation of the superficial ectoderm from the neural ectoderm, resulting in a focal segmental adhesion.
- Later during embryogenesis, the spinal cord ascends relative to the spinal canal and stretches the adhesion into a long, tubular tract.
- Dorsal dermal sinus manifests as a small dimple or pinpoint ostium, which is often associated with an area of hyperpigmented, angiomatous skin or hypertrichosis and occurs in a midline location or rarely in a paramedian location.
- Soft-tissue asymmetry and bone anomalies are common findings.
- Typical complications are infections such as recurrent meningitis, epidural or subdural abscess, and intramedullary spinal cord abscess.
- Dorsal dermal sinus occurring in a paramedian location is often associated with an intraspinal dermoid or Epidermoid, which causes compression of neural structures with neurologic symptoms.
 Imaging Findings for Dorsal dermal sinus
- US can show the entire length of the tract from the skin to the spinal cord.
- The tract can be difficult to identify within the subcutaneous fat.
- The tract is clearly demonstrated in the anechoic, cerebrospinal fluid–filled subarachnoid space as an echogenic structure.
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 References for Dorsal dermal sinus
- Karin M. Unsinn, Theresa Geley, Martin C. Freund, and Ingmar Gassner. US of the Spinal Cord in Newborns: Spectrum of Normal Findings, Variants, Congenital Anomalies, and Acquired Diseases. RadioGraphics 2000 20: 923-938.