Anesthesia for Neonatal Myelomeningocele

2021 ◽  
pp. 209-214
Author(s):  
Anna Clebone
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Spina Bifida ◽  
Neural Tube ◽  
Fetal Development ◽  
Vertebral Column ◽  
Bony Defect ◽  
Spinal Nerves ◽  
Spina Bifida Aperta ◽  
Human Fetal Development

Myelomeningocele, also known as spina bifida aperta (often shortened to the nonspecific name “spina bifida”) is a congenital disorder of the spine. In infants with a myelomeningocele, the neural tube has not closed, and the vertebral arches have not fused during development, leading to spinal cord and meningeal herniation through the skin. Because of the high potential for injury and infection of the exposed spinal cord, which could lead to lifetime disability, these lesions are typically repaired within 24 to 48 hours after birth. A myelomeningocele occurs before day 28 of human fetal development and is an abnormality in which the posterior neural tube closes incompletely. The outcome is a vertebral column deformity, through which the meningeal-lined sac herniates. After the bony defect is created, the hypothesized mechanism of meningeal herniation is that the pulsations of cerebrospinal fluid act progressively to balloon out the spinal cord. If the sac is filled with spinal nerves or the spinal cord, it is known as a myelomeningocele; if the sac is empty, it is called a meningocele.

Spina Bifida and Related Conditions

2017 ◽  
Author(s):  
Stephen L. Kinsman
Keyword(s):  
Spinal Cord ◽  
Spina Bifida ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Spinal Dysraphism ◽  
Gene Interactions ◽  
Tethered Spinal Cord ◽  
Spinal Lesion ◽  
Gene Environment ◽  
Spina Bifida Aperta

The term “spinal dysraphism” encompasses the broadest array of the conditions known as the neural tube defects. The open neural tube defects (spina bifida aperta and cystica) include both disorders of primary and/or secondary neuralation and are best defined as myelomeningocele complex (MMC) due to their protean nervous system manifestations beyond the spinal lesion. Closed spinal dysraphisms (so-called spina bifida occulta) include lipomatous lesions, forms of tethered spinal cord, sinus tracts, and forms of split spinal cord (diastematomyelia). Both genetic and environmental etiologies have been identified. Gene-environment and gene-gene interactions are also important in the pathobiology of these conditions.

Spinal Level

2017 ◽  
pp. 523-558
Author(s):  
Eduardo E. Benarroch ◽  
Jeremy K. Cutsforth-Gregory ◽  
Kelly D. Flemming
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Spinal Canal ◽  
Vertebral Column ◽  
Spinal Column ◽  
Foramen Magnum ◽  
Vascular Supply ◽  
Spinal Level ◽  
Spinal Nerves ◽  
Fluid Systems

The spinal level includes the vertebral column and its contents. The spinal canal within the vertebral column is the passage formed by the vertebrae. It extends from the foramen magnum of the skull through the sacrum of the spinal column and contains the spinal cord, nerve roots, spinal nerves, meninges, and vascular supply of the spinal cord. Five of the major systems are represented in the spinal canal: the sensory, motor, autonomic, vascular, and cerebrospinal fluid systems. The vascular and cerebrospinal fluid structures are the support systems of the spinal cord. Diseases of the spinal canal involve 1 or more of these systems and produce patterns of disease distinctive to this level. The anatomical and physiologic characteristics of the spinal cord and spinal nerves that permit the identification and localization of diseases in the spinal canal are presented in this chapter.

scholarly journals Open Neural Tube Defects: A Case Presentation of 30-year-old Secundigravida with Spina Bifida of the Fetus

2021 ◽  
Vol 4 (1) ◽  
pp. 411-417
Author(s):  
Anzhel S ◽  
Kovachev E ◽  
Tonchev AB ◽  
Georgiev B ◽  
Yaneva G ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Folic Acid ◽  
Spina Bifida ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
First Trimester ◽  
Folic Acid Supplementation ◽  
Patient Counseling ◽  
Case Presentation ◽  
Spina Bifida Aperta

Spina bifida is a neural tube defect that occurs in about 1 in 1,500 pregnancies. Open spinal defects are associated with paralysis, incontinence and hydrocephalus requiring postnatal shunting of the cerebrospinal fluid. Neural tube defects are preventable through preconceptional folic acid supplementation. Occasionally, the diagnosis is made during routine anomaly scan at 18-20 weeks of gestation, as the earliest signs of the anomaly can be seen at the end of first trimester. The information provided by ultrasound plays a crucial role in patient counseling and pregnancy management. The authors report a case of prenatal diagnosis of spina bifida aperta with focus on detailed ultrasound presentation and difficulties in consulting in relation to the prognosis for the newborns.

Interventional-Related Spine Anatomy

2018 ◽  
pp. 669-678
Author(s):  
Edward Jack Ebani ◽  
Kathryn Dean ◽  
Apostolos John Tsiouris
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Spinal Cord ◽  
Vertebral Column ◽  
Spinal Column ◽  
Imaging Findings ◽  
Spinal Nerves ◽  
Advantages And Disadvantages ◽  
Potential Sources ◽  
Magnetic Resonance Imaging Mri

This chapter on interventional-related spine anatomy provides a concise overview of normal spinal anatomy, as well as commonly encountered pathologic conditions, with a particular emphasis on the relevant imaging findings. The introduction outlines potential sources of back pain and their presenting symptomatology. The chapter reviews the main imaging modalities used to evaluate the spine and discusses their specific advantages and disadvantages. The anatomy of the muscles of the vertebral column, the vertebral column itself, and common variations), intervertebral ligaments and discs, vertebral joints, meninges and spinal cord, spinal nerves, and vasculature of the spinal column and spinal cord are reviewed. The discussion includes multiple radiographic, computed tomography (CT), magnetic resonance imaging (MRI), and angiographic images, as well as illustrations to supplement the text.

Developmental Overview of Central Neuroanatomy

2017 ◽  
Author(s):  
Peggy Mason
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Cerebral Cortex ◽  
Neural Tube ◽  
The Central Nervous System ◽  
Dorsal Telencephalon ◽  
Adult Spinal Cord ◽  
The Brain

The central nervous system develops from a proliferating tube of cells and retains a tubular organization in the adult spinal cord and brain, including the forebrain. Failure of the neural tube to close at the front is lethal, whereas failure to close the tube at the back end produces spina bifida, a serious neural tube defect. Swellings in the neural tube develop into the hindbrain, midbrain, diencephalon, and telencephalon. The diencephalon sends an outpouching out of the cranium to form the retina, providing an accessible window onto the brain. The dorsal telencephalon forms the cerebral cortex, which in humans is enormously expanded by growth in every direction. Running through the embryonic neural tube is an internal lumen that becomes the cerebrospinal fluid–containing ventricular system. The effects of damage to the spinal cord and forebrain are compared with respect to impact on self and potential for improvement.

scholarly journals Tethered cord syndrome with spina bifida aperta in cats: two case reports of different types

2017 ◽  
Vol 3 (1) ◽  
pp. 205511691770806 ◽  
Author(s):  
Masahiro Tamura ◽  
Takashi Oji ◽  
Satoshi Une ◽  
Makiko Mukaino ◽  
Tatsuro Bekki ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Urinary Incontinence ◽  
Spina Bifida ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Tethered Spinal Cord ◽  
Dural Sac ◽  
Spina Bifida Aperta ◽  
Different Types ◽  
Progressive Paraparesis

Case summary Two castrated male cats, aged 8 months old (case 1) and 10 months old (case 2), showed a history of progressive paraparesis, an over-reaching pelvic limb gait, urinary incontinence and a palpable dermoid fistula. In case 1, the fistula was connected to the dural sac on the conus medullaris, and the tethered spinal cord was retracted caudally. In case 2, the tubular structure was connected to the dural sac on the thoracic spinal cord, and the tethered spinal cord was retracted dorsally. Tethered cord syndrome secondary to spina bifida aperta was suspected in both cats. Excision of the fistula and release of the tethered spinal cord was performed. A histopathological examination confirmed the diagnosis of a meningomyelocele in case 1 and a meningocele in case 2. Paraparesis improved postoperatively in both cats. However, urinary incontinence in case 1 remained partially unresolved. Relevance and novel information This is the first report to describe the imaging characteristics, surgical treatments and outcomes of two different types of tethered cord syndrome with spina bifida aperta in cats. Tethered cord syndrome with spina bifida aperta needs to be included in the differential diagnosis of slowly progressive paraparesis in younger cats with or without vesicorectal failure and a palpable dermoid fistula.

Thoracic meningomyelocele associated with spina bifida in a Malinois dog

2019 ◽  
Vol 7 (3) ◽  
pp. e000894
Author(s):  
Clément Musso ◽  
Camille Bismuth ◽  
Laurent Cauzinille
Keyword(s):  
Spinal Cord ◽  
Spina Bifida ◽  
Spinal Cord Lesion ◽  
Fistula Tract ◽  
Clear Fluid ◽  
Ct Myelography ◽  
Spina Bifida Aperta ◽  
Healing Wound ◽  
Cord Lesion

An 8-month-old male Malinois dog was presented for progressive chronic pelvic limbs ataxia, paraparesis, arched back since ambulation associated with mild urinary and faecal incontinence. Clinical evaluation revealed a dorsocaudal thoracic spine non-healing wound with a fistula from which a clear fluid leaked. Neurological examination was compatible with a T3-L3 spinal cord lesion. CT myelography showed a T11-T12 spina bifida associated with a meningomyelocele with a fistula tract to the skin (spina bifida aperta). An MRI revealed a syringohydromyelia cranially and caudally to the meningomyelocele. Surgical correction involved removal of the fistula up to the dura mater and closure. A 4 and 12 months clinical and MRI follow up revealed a good locomotion improvement with residual mild ataxia without incontinence. MRI showed no relapse of the meningomyelocele but persistent although reduced syringohydromyelia.

scholarly journals SPINA BIFIDA;

2016 ◽  
Vol 23 (08) ◽  
pp. 893-901
Author(s):  
Muhammad Arslan Iqbal ◽  
Muhammad Zohaib Chaudhary ◽  
Muhammad Waseem Abbas ◽  
Faiza Maqsood ◽  
Fiza Fatima ◽  
...  
Keyword(s):  
Folic Acid ◽  
Environmental Factors ◽  
Spina Bifida ◽  
Neural Tube ◽  
Maternal Obesity ◽  
First Trimester ◽  
Developed Countries ◽  
Maternal Serum ◽  
Ultrasound Screening ◽  
Spina Bifida Aperta

Spina Bifida (SB) is a neural tube defect (NTD) due defect in neural tube,characterized by incomplete closure of spinal column. Occurrence of SB varies in differentcountries. In developed countries, it is about 0.4 per 1000 births, in US 0.7 per 1000 births and inAsia 1.9 per 1000 births. SB mostly occurs during first trimester of pregnancy. Variants of SB areSpina bifida Occulata, Spina bifida Cystica [meningocele and myelomeningocele], Spina bifidaManifesta and Spina bifida Aperta. Among these myelomeningocele is the most common type.Causing agents of SB may be genetic, non-genetic or environmental factors. Non-genetic factorsinvolve anti-convulsant drugs, anti-epileptic drugs, maternal obesity, maternal diabetes andpoor nutritional status (folate and vitamin B12 deficiency). Environmental factors are pesticides,nitrated compounds and air pollution. Common manifestations are brain malformations (ArnoldChiari II malformation and hydrocephalus), spinal cord abnormalities, latex allergy, breathingproblems, urological abnormalities and cardio-metabolic dysfunction. Diagnostic techniquesfor Spina bifida are ultrasound screening, Magnetic Resonance Imagining (MRI), amniocentesisand maternal serum alpha-fetoprotein. To prevent the risk of Spina bifida, it is recommended forthe mother to use 0.4mg of folic acid per day or in mothers affected with multiple pregnanciesrecommended dose of folic acid is 4mg per day.

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