Without Neurological Deficit: A Case Report

Abstract: Cervical myelomeningocoele is a rare dysraphic lesion which rarely presents with neurological deficit in affected infants. We report a 9-day-old female neonate with a posterior midline neck swelling and a large head noted at birth; that had a mid cervical myelomeningocoele and hydrocephalus without neurological deficit. All the brain ventricles were dilated on ultrasound and the fluid filled neck swelling showed no evidence of Chiari malformation or cord tethering. These associations were also absent during spinal exploration, repair of myelomeningocoele and ventriculo-peritoneal shunting. Except for a shunt revision necessitated by shunt blockade occurring 12 days after surgery, there has been no neurological deterioration since eighteen months of initial surgery. We conclude that an infant with cervical myelomeningocoele and hydrocephalus does not always have a Chiari malformation and could present without neurological deficit. A prolonged follow-up is however paramount in the event that the child may subsequently develop neurological deterioration. Key words: Cervical myelomeningocoele hydrocephalu