NEURAL TUBE DEFECT

Question 1

What is a neural tube defect

Answer 1

*Failure of closure of neural tube due to group of defects.

Question 2

3 clinical features of neural tube defect

Answer 2

*Swelling of back and neck,
*fever,
* crying.

Question 3

Risk Factors; of Neural tube defects

Answer 3

*Torch infections
*deficiency of folic acid
* exposure to radiation
*family history

Question 4

Name all the neural tube defects

Answer 4

• Spina Bifida:
• Myelocele
• M e n i n g o c e l e
• Myelomeningocele or
  Meningomyelocele:
• Myeloschisis

Question 5

Spina Bifida: name the types and define them

Answer 5

Types of spina Bifida
-Spina bifida cystica: occurs when the
neural tube fails to close, the vertebral arches fails to form and the neural tissues is exposed.
-spina bifida occulta: Adefect in vertebral arch with intact spinal cord and skin closure

Question 6

Myelocele, M e n i n g o c e l e define

Answer 6

• Myelocele (neural tube): is a sac like protrusion of the spinal cord through the posterior spinal defect
• M e n i n g o c e l e ( H e r n i a t i o n o f t h e meninges): there is an abnormal protrusion of the meninges through a bony defect without abnormalities of the underline neural tissue

Question 7

Myelomeningocele ,myeloschisis define them

Answer 7

*Myelomeningocele or
Meningomyelocele: most common, congenital absence of posterior vertebral element with protrusion of the meninges
through the defect and with underlying neural structural abnormality.
* Myeloschisis: an exposed spinal cord without leakage of CSF

Question 8

Investigations to carry out

Answer 8

• Maternal alpha-fetoprotein
• Amniotic fluid analysis (fetoprotein
• CBC, E/U/Cr, CT of the head, Transfontanelle US, Ultrasound, Skul X-ray, Swap M/C/

Question 9

Treatment of neural tube defects

Answer 9

1- Non pharmacological;
-Physiotherapy
-Cover swelling with saline soaked gauze Nurse baby in prone position.
- Screen for infection
2: -Pharmacological; -Antibiotics, Furosemide.
3: - Surgery; neurosurgery, shunt for hydrocephalus, orthopedics for limb deformities, urinary diversion.

Question 10

What is VACTERL is associated with neural tube defects

Answer 10

V- Vertebral anomalies
A-anal atresia
C-cardiac anomalies
T-tracheal-esophageal fistula
E-esophageal atresia, also duodenal atresia
R-renal structural anomalies
L-limb anomalies
H-hydrocephalus.