Presentation
Open spina defect in the thoracic region associated with meningomyelocele, lemon sign, and banana sign on a routine antenatal scan. The fetus also had bilateral clubfoot with scissoring of the lower limbs. Fetal growth and amniotic fluid index were normal.
Patient Data
Skull showing classical symmetrical frontal bone indentation called a lemon sign. The cerebellum appears curved like a banana. An open spine defect is seen in the thoracic region. Assocatied meningomyelocele is also present—persistent scissoring of lower limbs observed due to neural tube defect. Fetus also had an associated bilateral clubfoot.
Case Discussion
In most cases, Chiari II malformations can usually be detected on routine antenatal ultrasound. Findings of the lemon sign, banana sign, and open spine defect with meningomyelocele may be seen as early as 12 weeks of gestation. Early diagnosis can help make informed choices about the safe termination of pregnancy. The structural neural tube defect leading to a functional neurological deficit in the form of persistent scissoring of the lower limbs was a unique feature of this case.