Multiple neural tube defects in a child: A rare developmental anomaly
A 5-month-old female patient, first child of healthy parents, presented with two cystic swellings since birth, one in the suboccipital area and the other in the mid-thoracic region []. Parents had a nonconsanguineous marriage. Her perinatal history was uneventful.\nThe swellings were covered with skin and 10 × 9 × 7 cm and 7 × 6 × 4 cm in dimensions, respectively. The swellings were translucent and increased in tension when the child cried. The child was moving all four limbs normally and sphincter functions were unimpaired. Developmental assessment revealed normal milestones and growth parameters were within normal range.\nBrain MRI revealed herniation of meninges, CSF, and brain parenchyma through a midline defect in occipital bone consistent with meningoencephalocele. Hydrocephalous and features of Chiari malformation were also present.\nMRI thoracic spine demonstrated spina bifida from mid thoracic to upper lumbar spine with herniation of meninges, CSF, and neural elements at D7/8 levels diagnostic of meningomyelocele (MMC). The cord was low lying and tethered posteriorly with the intact posterior elements of D6. Syrinx was present in the cord proximal to the site of defect [].\nAxial T2- and T1-weighted MR images revealed a longitudinally split lower thoracic spinal cord with one dural tube and CSF intervening between the two hemicords []. No bony, cartilaginous or fibrous spur was identified along the course of the split cord consistent with Pang type 2- SCM.