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Journal of Child Neurology
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Infected Intraparenchymal Dermoids: An Underestimated Entity

Sandeep Mohindra, MCh, FRCS Edin

Department of Neurosurgery Postgraduate Institute of Medical Education and Research, Chandigarh, India,sandeepmohindra{at}gmail.com, mohindrasatyawati{at}yahoo.com

Rahul Gupta, MCh

Department of Neurosurgery Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Rajesh Chhabra, MCh

Department of Neurosurgery Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Sunil K. Gupta, MCh

Department of Neurosurgery Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Ashis Pathak, MCh

Department of Neurosurgery Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Amanjit K. Bal, MD

Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Bishan D. Radotra, MD

Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Infection secondary to a dermal sinus most commonly occurs in the form of cutaneous, epidural, or subdural abscesses. Rarely, it can result in an intramedullary abscess as a result of a dermal sinus. This study presents a clinicoradiological profile of 19 cases harboring abscesses within the dermoids and highlights the importance of dermal sinus acting as a pathway for infections to enter the nervous system. Emergent exploration, pus drainage, and minimal abscess wall excision along with prolonged antibiotic administration remained the management of choice in all cases. Methicillin-sensitive Staphylococcus aureus was the commonest offending organism. In all, 7 patients recovered to normal neurological status, 5 showed no improvement, and 7 improved partially. Improvement in motor power was noted, albeit partially, but bladder functions failed to recover even at long-term follow-up. Even when such infective complications of dermal sinuses are rare, these are potentially serious and disabling.

Key Words: dermoid • abscess

Journal of Child Neurology, Vol. 23, No. 9, 1011-1016 (2008)
DOI: 10.1177/0883073808316373
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