A nine month old boy was brought with the complaints of a swelling in the lower back since birth. On examination, there is a cystic swelling in the midline in the lower lumbosacral region.
There is dilatation of the lateral ventricles and the third ventricle. (Evan’s index 0.58). The posterior fossa is small; the contents crowded. There is herniation of the cerebellar tonsils and vermis with effacement of the fourth ventricle which is elongated and caudally displaced. The posterior fossa is small.. hinning The corpus callosum is thin and displaced upward. There is a defect in the posterior elements between L5 and S2 vertebrae with posterior herniation of a CSF filled sac containing spinal cord and nerve fibres