Occipital Dermal Sinus Tract Causing Craniospinal Infection: A Review

Dermal sinus is a rare congenital condition characterized by a pathological tract connecting the skin to deeper tissues of the central nervous system, potentially leading to severe infectious complications. It arises from a failure in the separation of ectodermal layers during early gestation. Diagnosing dermal sinus tract in newborns requires a careful physical examination, focusing on midline dimples in the occipital region associated with cutaneous abnormalities like hairy nevus or hyperpigmentation. The presence of drainage, abnormal hair distribution, or localized swelling may indicate a sinus tract. Regular examination for dimples or sinuses is recommended for infants and children with recurrent meningitis or infections. Early detection is crucial to prevent severe complications like meningitis, with Staphylococcus aureus being a common causative organism. Neuroradiological studies, including computed tomography (CT) scan and magnetic resonance imaging (MRI), with histopathological examination are crucial for diagnosing dermal sinus tract and associated cysts. Neurosurgical intervention is important to prevent intracranial infection. Treatment involves suboccipital craniectomy, cyst and tract removal, with caution about potential complications and recurrence.