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Table 1 Characteristics of two patients diagnosed with spinal dysraphism with a hamartomatous growth (appendix) of the spinal cord

From: Genetic analysis of spinal dysraphism with a hamartomatous growth (appendix) of the spinal cord: a case series

 

Patient 1

Patient 2 (Fig. 1)

Gender

Female

Male

Age (years)

59

37

Level

th8

th7

Previous history

Hypertension

Car accident 10 years prior without severe injuries

Medical history

Pregabalin, Valsartan

Amitriptyline, Omeprazole

Family history

Uneventful

Uneventful

Psychosocial history

Recreational alcoholic consumption, non-smoker, housewife, married

Recreational alcoholic consumption, smoker, unemployed, married

Duration of symptoms

1 year

10 years, soon after the accident

Course until presentation

Progressive

Somewhat gradually

Clinical symptoms

Loss of sensitivity to touch, pain, and temperature in the left leg, buttock, and side of the torso below the ribcage; less strength in the left leg

Dull pain initially only on the left side and discrete loss of sensitivity in a 6-in. band around the ribcage; later, sensitivity was also altered in the left leg; strength remained normal

Physical exam

Vital and gnostic sensibility loss distal to th10 on the left side, discrete paresis of the left biceps femoris muscle (MRC grade 4/5), and symmetrical hyporeflexia in the arms and legs, except for a positive Babinski’s sign on both sides

Sensibility loss distal to th12 on the left side; motor strength and reflexes were normal

Treatment

Surgical exploration and untethering of the spinal cord

Refused surgery

Course

Two years postoperatively: no progression of clinical signs and symptoms after an uneventful postoperative course

Remained very afraid of surgery three years after his first presentation although the clinical signs and symptoms slowly but gradually had worsened