OCCULT DYSRAPHISM IN ADULTHOOD - CLINICAL COURSE AND MANAGEMENT

We present a series of 23 patients with dysraphic malformations and ad ult onset of symptoms (4 meningoceles, 19 spinal hamartomas). Mean age at presentation was 39 +/- 21 years (range 23 +/- 67 years). Patients were followed up for a mean period of 19 months (range 0.5-68 months) . Only patients with progressive neurological disease were operated on (3 meningoceles and 16 spinal hamartomas). The remaining patients wer e treated conservatively and continue to be observed clinically. Two o f three patients operated for meningoceles improved without recurrence of symptoms. Patients with spinal hamartomas could be divided into tw o groups according to their main symptom: paraparesis (group A, n = 8) or pain (group B, n = 11). Malformations in group B were typically as sociated with a tethered cord and tended to be more complex than in gr oup A. The majority of patients in group A showed better long-term res ults than patients in group B, due to their considerably lower rate of recurrence.