Anterior cervical meningomyelocele in a neonate

摘要

Sir, Anterior cervical meningomyelocele (ACM) is rare. The patient expired in the follow up after 2 months. We report this extremely rare neural tube defect in a 1-month baby girl and the challenges and complications we faced in its management. This case is the only one described in neonate.A month-old baby girl presented with repeated respiratory tract infections at another facility. Chest X-ray revealed right lung haziness. Suspecting right pleural effusion, inadvertently right intercostal drain (ICD) was placed and clear cerebrospinal fluid (CSF) was drained. Subsequently, the child was referred to our center. Examination in the emergency department the child was conscious, moving all limbs, oxygen saturation 90% and pus was draining at the ICD site. Magnetic resonance imaging of the entire spine showed large ACM at C6 level extending inferiorly into the posterior mediastinum and causing right lung collapse and hydrothorax [Figures 1 and 2]. The C6 vertebral body was incompletely formed in the midline and Ryles tube was displaced to the right side. A dysplastic neural placode [Figure 1] was seen at the neck of the myelomeningocele sac and the cord showed a short segment syrinx [Figure 1] at the same level. Upper dorsal scoliosis due to hemivertebrae was seen. Other relevant investigations were normal.