Open AccessFirst trimester cerebral appearance in the presence of closed spina bifida with myelomeningocele, part of the oeis complex
Author(s) -
Delia Roxana Ungureanu,
George Lucian Zorilă,
R. Capitanescu,
Dominic Gabriel Iliescu
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-235395
Subject(s) - spina bifida , medicine , cerebral spinal fluid , hindbrain , spinal dysraphism , lesion , spinal cord , cerebrospinal fluid , neural tube defect , amniotic fluid , fetus , pregnancy , surgery , central nervous system , anesthesia , pathology , psychiatry , biology , genetics
Our communication presents a prenatally detected case with severe spinal defect detected in the first trimester of pregnancy, accompanied by a large skin-covered myelomeningocele but normal cranio-cerebral structural appearance.These findings suggest that in the first trimester, the extent of the spinal defect, the cerebrospinal fluid leakage to a large, but skin-covered, meningocele and fixation of the spinal cord at the lesion are not sufficient to determine downward hindbrain displacement and the development of secondary signs for open spina bifida.Therefore, we suggest a careful evaluation of the fetal cerebral features if a meningocele is detected. The presence of the skin covering the lesion may not be evident in the first trimester, but the absence of intracranial open spina bifida markers may indicate a 'closed' spinal defect, which generally associates a good neurological outcome. Also, studies aimed to investigate the accuracy of the intracranial features for open spina bifida detection should consider the possibility of 'closed' myelomeningoceles to avoid incorrect correlations.