Thoracic and lumbar multiple neural tube defects with post repair hydrocephalus: A case report and literature review

Abstract

Background: Neural tube defects are among the most common congenital anomalies, particularly in developing countries owing to significant folic acid deficiency. Nevertheless, multiple-site open neural tube defects are extremely rare. Cerebrospinal fluid diversion procedures were required in a quarter of patients with multiple site open neural tube defects. Hence, we report the tenth case of thoracic and lumbar multiple neural tube defects in the literature and emphasize the need for cerebrospinal fluid diversion in these groups of patients. Case presentation: Here we present two days old female neonate who presented with two back swellings. Physical examination revealed thoracic and thoracolumbar unruptured meningomyelocele with ulcerated neural placode. Single-stage closure of both defects was accomplished. Two months later ventriculoperitoneal shunting was done for post-repair hydrocephalus. Conclusion: Multiple site open neural tube defects are extremely rare with a unique, yet controversial embryogenesis. Single-stage closure can be performed safely. The development of hydrocephalus and need for shunting procedures in these group of patients reported to be lower than the single site open neural tube defects. Therefore, the requirement for cerebrospinal fluid diversion after the closure of these defects needs further studies.

Keywords

• Myelomeningocele
• Multiple-site neural tube defect
• Hydrocephalus