{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:37:35Z","timestamp":1790696255433,"version":"4.1.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,6]],"date-time":"2019-11-06T00:00:00Z","timestamp":1572998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,6]],"date-time":"2019-11-06T00:00:00Z","timestamp":1572998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Triple neural tube defects are rare. To the author\u2019s knowledge, there are only four reported cases available in the literature up to date. Controversies exist with regards to the development of neural tube defects. We revisit the multisite closure theory and try to explain the mechanism of neural tube defects in our case.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>We report a case of one-month-old baby boy who presented to us with three distinct neural tube defects. He had occipital and cervical encephaloceles along with thoracolumbar myelomeningocele accompanied by syrinx and mild hydrocephalus. All the three defects were surgically corrected with good neurological outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In the multisite model of human neural tube closure, there are only two fusion sites and two neuropores unlike in mouse. This can explain the origin of open neural tube defects including anencephaly and myelomeningocele (as in our case) but cannot account for the development of encephalocele, which appears to be a post neurulation defect.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12893-019-0633-2","type":"journal-article","created":{"date-parts":[[2019,11,6]],"date-time":"2019-11-06T16:03:26Z","timestamp":1573056206000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A case report of triple neural tube defect: revisiting the multisite closure theory"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6333-2107","authenticated-orcid":false,"given":"Jayant Kumar","family":"Yadav","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahtesham","family":"Khizar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradhumna Kumar","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghulam","family":"Mustafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajid Nazir","family":"Bhatti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,6]]},"reference":[{"issue":"4","key":"633_CR1","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/s00381-004-1027-y","volume":"21","author":"IH Tekk\u00f6k","year":"2005","unstructured":"Tekk\u00f6k IH. Triple neural tube defect - cranium bifidum with rostral and caudal spina bifida - live evidence of multi-site closure of the neural tube in humans. Childs Nerv Syst. 2005;21(4):331\u20135.","journal-title":"Childs Nerv Syst"},{"issue":"February","key":"633_CR2","doi-asserted-by":"publisher","first-page":"160","DOI":"10.3171\/PED\/2008\/1\/2\/160","volume":"1","author":"D Srinivas","year":"2008","unstructured":"Srinivas D, Sharma B, Mahapatra A. Triple neural tube defect and the multisite closure theory for neural tube defects: is there an additional site? J Neurosurg Pediatr. 2008;1(February):160\u20133.","journal-title":"J Neurosurg Pediatr"},{"issue":"2","key":"633_CR3","doi-asserted-by":"publisher","first-page":"e5","DOI":"10.1016\/j.jpedsurg.2010.09.103","volume":"46","author":"S Mahalik","year":"2011","unstructured":"Mahalik S, Vaze D, Lyngdoh T, Tewari M, Narasimhan K. Embryogenesis of triple neural tube defects: sonic hedgehog \u2013 a key? 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Anat Embryol (Berl). 2000;201(6):455\u201366.","journal-title":"Anat Embryol (Berl)"},{"key":"633_CR8","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1002\/ajmg.1320470528","volume":"743","author":"M Van Allen","year":"1993","unstructured":"Van Allen M, Kalousek DK, Chernoff GF, Juriloff D, Harris M, Mcgillivray BC, et al. Evidence for multi-site closure of the neural tube in humans. Am J Med Genet. 1993;743:723\u201343.","journal-title":"Am J Med Genet"},{"issue":"4","key":"633_CR9","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1002\/tera.10007","volume":"65","author":"R O\u2019Rahilly","year":"2002","unstructured":"O\u2019Rahilly R, Muller F. The two sites of fusion of the neural folds and the two neuropores in the human embryo. 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We confirm that we have read the Journal\u2019s position on issues involved in ethical publication and affirm that this case report is consistent with those guidelines.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"164"}}