Multiple neural tube defects in the same patient with no neurological deficit

Abstract

Congenital deformities involving the coverings of the nervous system are called neural tube defects (NTDs). NTD can be classified as neurulation defects, which occur by stage 12, and postneurulation defects. Cervical meningocele and myelomeningocele are rare spinal dysraphic lesions. Unlike lumbosacral dysraphic lesions, there is often no neurologic deficits and thus the subtle features of cervical cord tethering may be overlooked on imaging. The presence of meningomyelocele and/or encephaloceles at multiple (two or more) sites along the vertebral axis is a very rare event occurring in <1% of cases. Less than 10 cases have been described in the published literature. We are reporting a case of multiple NTD in same patient with no neurological deficit.

Keywords: Dermal sinus; meningomyelocele; neral tube defect; tethered cord.

Figure 1

Patient having swelling in the cervical region, which was present since birth, and sinus in the thoracic region in midline

Figure 2

Magnetic resonance imaging (MRI) of the spine showing tethering of the cord with lipomatous filum terminale and cervicothoracic MRI showing swelling at the C2–C4 level and sinus at the D4 level