Klinik und Differentialdiagnose der cranialen Migrationshemmung des Rückenmarks

Zusammenfassung Nach einer Literatur-und pathomorphologischen Übersicht wird an Hand von 23 Fällen einer spinalen Malformation unterschiedlicher Genese das klinische Bild der cranialen Migrationshemmung herausgearbeitet. Für die Diagnose ist neben Hautveränderungen über der dorsalen Mittellinie, wie sie für den dysrhaphischen Formenkreis typisch sind, die neurologische Symptomatik der unteren Extremitäten richtungweisen. Der Beweis einer Aszensionshemmung kann nur durch die Myelographie erbracht werden. Die Bedeutung frühzeitiger operativer Maßnahmen zur Verhinderung progredienter Ausfälle wird besonders herausgestellt.

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Clinical features and differential diagnosis of the restricted cranial migration of the spinal cord

After a review of the literature on, and the pathology of spinal malformations the clinical features of a restricted ascent of the spinal cord are described with reference to 23 cases of spinal dysrhaphism of varying genesis. The suppression of cranial migration is caused either by a diastematomyelia, a lipoma, or a dermoid sinus with direct connection to the spinal cord, or else by myelomeningoceles and cicatrices after arachnitis.The symptoms occur particularly during the early years of life and in the age group of between 20 and 30.The manifestations of the disease are changes over the dorsal midline which are typical for spinal dysraphism, neurological defects of the lower limbs, and abnormalities in the function of bladder and rectum. Deformations of the feet and trophic disturbances have been encountered.Important for the diagnosis is a radiographic investigation of the spine since a restriction of the cranial migration can only be proved by myelography. Operation with view of a release of the spinal cord is the method of choice. The importance of early operative measures for the prevention of progredient deficiencies is particularly stressed.