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| CLINICAL IMAGE |
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| Year : 2022 | Volume
: 19
| Issue : 2 | Page : 118-119 |
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High-resolution ultrasonography in open spinal dysraphism: Spina bifida with lumbosacral myelomeningocele
Ravikanth Reddy
Department of Radiology, St. John's Hospital, Bengaluru, Karnataka, India
| Date of Submission | 07-Aug-2021 |
| Date of Decision | 28-Aug-2021 |
| Date of Acceptance | 12-Oct-2021 |
| Date of Web Publication | 06-Dec-2021 |
Correspondence Address:
Ravikanth Reddy
Department of Radiology, St. John's Hospital, Bengaluru - 560 034, Karnataka
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/am.am_93_21
How to cite this article:
Reddy R. High-resolution ultrasonography in open spinal dysraphism: Spina bifida with lumbosacral myelomeningocele. Apollo Med 2022;19:118-9 |
| Description | |  |
An 18-year-old primigravida woman from a rural background presented to the department of obstetrics and gynecology for routine antenatal checkup and fetal well-being and was referred to the department of radiology for a fetal anomaly scan. She had no significant family history. Ultrasonography performed at 20 weeks demonstrated posterior spinal defect at lumbo-sacral level with evidence of a myelomeningocele and splaying of posterior elements [Figure 1]a, [Figure 1]b ,[Figure 1]c. However, there is a lemon sign or banana sign which are the classic signs of Chiari type II malformation were not demonstrable. Furthermore, there was no ventriculomegaly to suggest hydrocephalus. A provisional diagnosis of spina bifida with lumbosacral myelomeningocele was made which was later confirmed at a tertiary care center. Following extensive genetic counseling, parents had opted for pregnancy termination. | Figure 1: (a) Sagittal view of the spine demonstrating a defect at the lumbosacral region (arrow). (b) Axial view demonstrating defect of the vertebral arch with splaying of posterior elements consistent with spina bifida (arrows). (c) Axial view of the myelomeningocele (star) at the lumbosacral region containing cerebrospinal fluid collection covered by meninges
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| Discussion | | |
Spinal dysraphisms refer to group of neural tube defects or malformations that affect embryological development of the dorsum of spine and adjacent structures. Open spinal dysraphisms refer to dorsal spinal malformations with exposed cord and covering membranes and with no skin. Spina bifida refers to neural tube defect with a slight female preponderance of 1.2:1 over males and has an incidence rate of 1–2 cases per 1000 population.[1] Neural tube defects refer to teratogenic malformations secondary to neural tube closure defects and abnormal differentiation of related structures. Some of the noted neural tube defects commonly encountered include anencephaly, meningocele, myelomeningocele, encephalocele, and spina bifida occulta.[2] Myelomeningocele is the most common among them and constitutes nearly 98% of the listed open spinal dysraphisms which is also associated with other concurrent fetal anomalies such as congenital hip dislocation and syringomyelia.[3] Folic acid supplements during the antenatal period is known to reduce the risk of neural tube defects such as myelomeningocele.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Brea CM, Munakomi S. Spina bifida. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021.  |
| 2. | Greene ND, Copp AJ. Neural tube defects. Annu Rev Neurosci 2014;37:221-42. |
| 3. | Iftikhar W, De Jesus O. Spinal dysraphism and myelomeningocele. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. |
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