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

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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