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Sinus Cysts

Figure 1.68. A midline occipital defect consisting of a tag with some cystic formation is seen in this infant. In any infant with a midline lesion anywhere from the back of the neck to the lower end of the spine, it is mandatory to investigate the neural axis. The lesions may consist of small sinuses, cysts, or hemangiomas.

Figure 1.67. The large skin fold on the back of this infant was hard and fibrotic. It was believed to have occurred as a result of the skin being "pinched" in utero from intrauterine constraint very early in gestation.

Figure 1.68. A midline occipital defect consisting of a tag with some cystic formation is seen in this infant. In any infant with a midline lesion anywhere from the back of the neck to the lower end of the spine, it is mandatory to investigate the neural axis. The lesions may consist of small sinuses, cysts, or hemangiomas.

Figure 1.69. This infant presented with a midline heman-gioma associated with a midline tuft of hair over the spine. Further investigation confirmed the presence of a neural axis defect. If hair tufts are associated with any of these lesions, the risk is even greater.

Figure 1.70. Pilonidal dimples are extremely common in neonates. If the base of the dimple can be seen easily, further investigation is not necessary. If the dimple is very deep or appears to be a sinus tract it is important to do a neurologic evaluation.

Figure 1.72. In this infant there is a midline defect over the distal end of the spine. With this type of lesion it is mandatory to do further studies. MRI confirmed the presence of a tethered cord syndrome. Note the "bandaid sign" in this infant confirming that the infant had a spinal tap performed as part of a sepsis evaluation. This was contraindicated in this infant because of the midline skin defect.

Figure 1.70. Pilonidal dimples are extremely common in neonates. If the base of the dimple can be seen easily, further investigation is not necessary. If the dimple is very deep or appears to be a sinus tract it is important to do a neurologic evaluation.

Tuft Hair The Dimple

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