Multisite neural tube defects: Management of a complex case and review of theories on neural tube closure

Surgery Case Reports Pub Date : 2025-03-01 Epub Date: 2024-12-15 DOI:10.1016/j.sycrs.2024.100083
Ubaid Ullah , Malik W.Z. Khan , Aamina Sher , Hammad Iftikhar , Aizaz Ali , Shandana Ali , Salman Khan , Sajjad Ullah
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Abstract

Background

Neural tube defects (NTDs) result from incomplete neural fold fusion during early embryonic development and can occur at various stages (gastrulation, primary, and secondary neurulation). While rare, NTDs at multiple sites require clinical and imaging assessments for management. The "Zipper closure" and "Multisite closure" theories explain these defects, though some anomalies remain unexplained, calling for more research.

Case Presentation

A two-month-old female presented with two NTDs: occipital meningoencephalocele and lumbar myelomeningocele. Both defects were successfully treated surgically, leading to positive neurological outcomes.

Conclusion

This case supports the multisite closure theory of NTDs and emphasizes the importance of early surgical intervention to prevent complications.
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多部位神经管缺损:一例复杂病例的处理及神经管闭合理论综述
神经管缺陷(NTDs)是由于胚胎早期发育过程中神经褶融合不完全引起的,可发生在不同阶段(原肠胚形成、原发性和继发性神经发育)。虽然罕见,但在多个地点出现的热带病需要临床和影像学评估以进行管理。“拉链闭合”和“多位点闭合”理论解释了这些缺陷,尽管一些异常仍然无法解释,需要更多的研究。一个两个月大的女性表现为两个NTDs:枕骨脑膜脑膜膨出和腰椎脊膜脑膜膨出。手术成功地治疗了这两种缺陷,导致了积极的神经系统预后。结论本病例支持NTDs多部位闭合理论,强调早期手术干预对预防并发症的重要性。
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