Developmental Neuropathology
Chapter 14: Spinal cord lesions
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Many variable disorders with poor understanding of pathogenesis. They often occur in combination with, e.g., meningomyelocele or Chiari I malformation.

Hydromyelia: dilation of central canal from incomplete fusion of the posterior columns or persistence of the primitive large canal of the embryo. Can be focal, esp. lumbar. Often isolated incidental finding in neonatal autopsy. Often found in association with Chiari I or II malformations.

Syringomyelia: dilated, glial-lined cavity in spinal cord. Syringobulbia in the brainstem. This cavity does not communicate with the central canal, and usually is between the dorsal columns unilaterally or bilaterally along the side of the cord.

Diplomyelia: duplication of the spinal cord

Diastomatomyelia: coexistence of two hemicords, at variable levels, causing splaying of the posterior vertebral elements. Results in neurological deficits in lower limb or perineum.

Hemicords can be separated by rigid osseocartillaginous septum (Split cord malformation type I) or in a single dural sac separated by a fibrous median septum (Split cord malformation type II).

Both diplomyelia and diastomatomyelia can occur concurrently. Usually symptomatic in adults and not in children. Can be incidental finding on neuroimaging.

Triplomyelia: triplication of the spinal cord extremely rare

Spinal tract defects: include aplasia of the corticospinal tracts or dorsal columns, asymmetric crossing of spinal tracts, or fusion of tracts across the midline.

Risk factors


Clinical features

Imaging and biochemistry



Differential diagnosis


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