Junctional neural tube defect in a newborn: report of a fourth case

Childs Nerv Syst. 2017 May;33(5):873-875. doi: 10.1007/s00381-017-3353-x. Epub 2017 Feb 28.

Abstract

Introduction: A discontinuous, functionally disconnected spinal cord is an extremely rare finding, with only three known reports in the literature. Titled junctional neural tube defect (JNTD), this newly reported dysraphism is believed to arise from a developmental error occurring during junctional neurulation, a transitory stage of development marked by the end of primary neurulation and the beginning of secondary neurulation. Herein, we report a newborn case of JNTD.

Case report: We report a newborn boy born with anorectal atresia. Physical examination revealed normal movement in the upper and lower extremities. Imaging revealed distal sacral agenesis and a spinal cord that was discontinuous at the thoracolumbar junction. Three vertebral segments inferiorly, at the L2 vertebral level, the distal end of the spinal cord (i.e., conus medullaris) were visualized. No signs of a tethered cord were identified.

Conclusions: Characterized by an error in junctional neurulation in which the primary and secondary NT fail to integrate appropriately, JNTD has been recently classified. We believe the current patient to represent only the fourth reported case of JNTD in the literature.

Keywords: Anatomy; Imaging; Junctional neural tube defect; Junctional neurulation; Malformation; Primary and secondary neurulation; Spinal cord; Spinal dysraphism.

Publication types

  • Case Reports

MeSH terms

  • Anorectal Malformations / complications
  • Anorectal Malformations / diagnostic imaging*
  • Humans
  • Infant, Newborn
  • Male
  • Neural Tube Defects / complications
  • Neural Tube Defects / diagnostic imaging*