title: Multiple neural tube defects: a clinical series of seven cases and their embryological basis.
abstract: BACKGROUND
  There have been isolated cases of such multiple neural tube defects (MNTDs) described in the world literature. We report 7 cases of MNTDs and review the available literature.
  
  
  METHODS
  This retrospective study included all patients who were managed with MNTDs at our institute from 2001 to 2006.
  
  
  RESULTS
  Among a total of 474 cases of neural tube defects,7 patients had MNTDs. Among these, 5 had a double neural tube defect while 2 had a triple neural tube defect. Six were operated upon successfully while 1 patient refused any form of intervention.
  
  
  CONCLUSIONS
  The presence of meningomyelocele and/or encephaloceles at multiple (two or more) sites along the vertebral axis is a very rare event occurring in <1% of cases. Less than 10 cases have been described in the published literature. This series is the largest so far on these rare anomalies. We also discuss the embryogenesis, which is better explained by the multisite closure theory.
authors.affiliation: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: F U
authors.initials: FU
authors.lastname: Ahmad
authors.forename: S
authors.initials: S
authors.lastname: Dwarakanath
authors.forename: B S
authors.initials: BS
authors.lastname: Sharma
authors.forename: A K
authors.initials: AK
authors.lastname: Mahapatra
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008591:Meningomyelocele / Q000196:embryology / Q000473:pathology* / Q000601:surgery; D009436:Neural Tube Defects / Q000196:embryology / Q000473:pathology* / Q000601:surgery