{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:39Z","timestamp":1756339419419,"version":"3.44.0"},"reference-count":24,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,9,6]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Our communication presents a prenatally detected case with severe spinal defect detected in the first trimester of pregnancy, accompanied by a large skin-covered myelomeningocele but normal cranio-cerebral structural appearance.<\/jats:p>\n               <jats:p>These findings suggest that in the first trimester, the extent of the spinal defect, the cerebrospinal fluid leakage to a large, but skin-covered, meningocele and fixation of the spinal cord at the lesion are not sufficient to determine downward hindbrain displacement and the development of secondary signs for open spina bifida.<\/jats:p>\n               <jats:p>Therefore, we suggest a careful evaluation of the fetal cerebral features if a meningocele is detected. The presence of the skin covering the lesion may not be evident in the first trimester, but the absence of intracranial open spina bifida markers may indicate a \u2018closed\u2019 spinal defect, which generally associates a good neurological outcome. Also, studies aimed to investigate the accuracy of the intracranial features for open spina bifida detection should consider the possibility of \u2018closed\u2019 myelomeningoceles to avoid incorrect correlations.<\/jats:p>","DOI":"10.1136\/bcr-2020-235395","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T17:15:14Z","timestamp":1602177314000},"page":"e235395","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["First trimester cerebral appearance in the presence of closed spina bifida with myelomeningocele, part of the oeis complex"],"prefix":"10.1136","volume":"13","author":[{"given":"Delia Roxana","family":"Ungureanu","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova Faculty of Medicine, Craiova, 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