ATYPICAL AND EQUIVOCAL SONOGRAPHIC FEATURES OF THE SPINAL-CORD IN NEONATES

Thanks to the wider use of sonography to examine the spinal content in the neonate, normal anatomy and anomalies may be detected easily. Yet , unusual sonographic patterns are also observed. These must be differ entiated from true pathologies. During a prospective study of 103 neur ologically asymptomatic neonates, atypical sonographic patterns were f ound in 16 patients, corresponding to normal variants in 13. Nine of t hese 13 patients presented with a widening of the distal part of the c entral echo complex (one had a dilated ventriculus terminalis). Nerve roots of the cauda equina were disposed asymmetrically in three patien ts; the spinal cord movements were still present. In two of these babi es, this distribution was associated with thin arachnoid pseudocysts. One patient presented with transitorily hyperechoic and narrow subdura l spaces, probably related to neonatal dehydration. None of the 13 pat ients showing normal variants required any treatment. The other 3 pati ents (of 16) presented with equivocal entities of unknown evolution: s onographic tethered cord, fibrolipoma of the filum terminale and epidu ral varices. Sonography is highly accurate in evaluating the spinal co rd content and aids differentiation of normal and normal variants from equivocal or pathological entities.