Neural Tube Defects Flashcards
What is anencephaly? How is it detected? What is the prognosis?
Cranial vault absent- brain open
Detected on 20w anomaly USS + TOP offered
Stillborn/ die quickly
What is encephalocele? What is the prognosis?
Herniation/ extrusion of brain + meninges
Often underlying cerebral malformation
Can be corrected surgically
What is spina bifida occulta?
Mildest form
Incomplete closure of posterior vertebral arch
No protrusion of spinal cord
Most unaware- incidental finding
What finding should prompt further investigations in spina bifida occulta? What investigation is indicated?
Tuft of hair, sinus, port-wine stain, subcutaneous mass in lumbosacral area
MRI spine
What symptoms can occur in spina bifida occulta?
Asymmetrical LMN weakness a/w wasting, deformity + diminished reflexes.
Progressive gait disturbance with spasticity
Impaired bladder control
What does spina bifida result from? What are the 3 main types (from least to most severe)?
incomplete closure of the neural tube at the caudal end (mostly in lumbar region)
Spina bifida occulta
Meningocele
Myelomeningocele
What is a meningocele?
Protrusion of meninges filled with CSF through defect in skull/ spine
Cord remains intact + functions normally
What is a complication of meningoceles?
Sac can rupture
Increases risk of meningitis + hydrocephalus
Thus, surgical correction needed
What is a myelomeningocele?
Meningeal sac herniates through defect in lower vertebrae
Contains elements of spinal cord + limbo-sacral roots
What 5 symptoms are caused by myelomeningoceles?
Minimal bladder dysfunction
Paresis + hypotonia of LL
Sensory loss
Incontinence
Hydrocephalus
When is spina bifida detected?
Closed spina bifida: may be incidental finding on XR in children
Open spina bifida: 20w anomaly scan
