Seven distinct coexistent cranial and spinal anomalies.
Existence of multiple cranial and spinal anomalies in spina bifida is well known; however, coexistence of seven different severe anomalies is extremely rare. The location of the anomalies, the patient's age and presentation are other interesting aspects of the presented case.


METHODS
A 1-year-old girl with an enlarged head and big, infected lumbosacral myelomeningocele (MMC) was admitted to the emergency department in a comatose state. Further investigations revealed hydrocephalus, Chiari malformation, syringohydromyelia, split cord malformation, dermal sinus tract, lumbosacral MMC, and tethered cord. Unfortunately, the patient died 3 days after admission because of meningitis and sepsis.


CONCLUSIONS
Coexistence of seven different craniospinal anomalies is extremely unusual. Further investigations with magnetic resonance imaging for associated anomalies, early shunt placement and MMC repair are required to prevent this life-threatening condition in spina bifida.
Emmez
Hakan
H
Department of Neurosurgery, Gazi University School of Medicine, Ankara, Turkey. hakanemmez@hotmail.com
Tokgöz
Nil
N
Dogulu
Fikret
F
Yilmaz
Muhammed Bahadir
MB
Kale
Aydemir
A
Baykaner
M Kemali
MK
D002508:Cephalometry; D017809:Fatal Outcome; D005260:Female; D006257:Head / Q000002:abnormalities*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications; D007223:Infant; D008581:Meningitis / Q000150:complications; D009436:Neural Tube Defects / Q000150:complications*; D018805:Sepsis / Q000150:complications; D013116:Spinal Cord / Q000002:abnormalities*; D013595:Syringomyelia / Q000150:complications*