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January 1961

Rupture of the Neural Tube: The Cause of Myelomeningocele

Author Affiliations

From the Department of Neurological Surgery, the Cleveland Clinic Foundation, and the Frank E. Bunts Educational Institute.

Arch Neurol. 1961;4(1):1-7. doi:10.1001/archneur.1961.00450070003001

Speaking of myelomeningocele, 2 centuries ago Morgagni1 stated his belief that these watery tumors of the vertebrae result from the pressure of fluid descending in the tube of the spine from the hydrocephalic head, producing a dropsy of both together. Since then, anatomic, embryologic, and experimental evidence has accumulated in support of this hydromyelic theory.

In 1886 von Recklinghausen2 showed that the sac of the myelomeningocele contains an open portion of the neural tube. This finding led him to disagree with Morgagni's concept and to assume that the primary defect is a failure of the tube to close. Until now this araphic theory has remained virtually unchallenged, despite the fact that there is nothing but the appearance of the local lesion to support it.

It is well known that a dilatation of the lumen of the craniovertebral axis is present in the infant with myelomeningocele and that within

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