SPONTANEOUS PNEUMOCEPHALUS IN A NEWBORN-INFANT WITH MYELOMENINGOCELE AND HYDROMYELIA

The authors report a preterm boy, born at 35 weeks gestation with hydr ocephalus and an open sacral myelomeningocele. Cranial ultrasound show ed ventricular dilatation with posture-dependent intraventricular brig ht echoes, representing air. Ultrasound of the cervical spine and the craniocervical junction revealed marked hydromyelia of the whole spina l cord, as well as a Chiari II malformation. Air penetrating the enlar ged central canal through the neural tube defect and subsequently asce nding to the cranial cavity was demonstrated by fluoroscopy. After a r eview of the literature, the authors conclude that the association of spontaneous pneumocephalus with myelomeningocele could indicate severe hydromyelia. These malformations are readily demonstrated by ultrasou nd in newborn infants.