scholarly journals Anesthetic management of cesarean section of a wheelchair bound parturient with myelomeningocele

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Shankar Lal ◽  
Umair Akram ◽  
Tharwat Aisa ◽  
Adil Sher ◽  
Zulfiqar Memon ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Cesarean Section ◽  
Anesthetic Management ◽  
Tethered Cord ◽  
Health Care Facilities ◽  
Spina Bifida Occulta ◽  
Neurologic Impairment ◽  
First Case ◽  
Modern Health Care ◽  
Neuroenteric Cyst

Neural tube defects (NTD) affect 1-2 in 1000 pregnancies over the world. The most frequent spinal dysraphisms are meningocele and myelomeningocele while the spina bifida occulta, tethered cord, lipomyelomeningocele, split cord malformations, neuroenteric cyst, and several other conditions occur less frequently. Open spinal dysraphisms (meningocele and myelomeningocele) are compatible with postnatal survival, but they can result in severe neurologic impairment as inability to ambulate, urinary incontinence, hydrocephalus, scoliosis, and gastrointestinal (GI) disorders. Closed spinal dysraphisms (spina bifida occulta, tethered cord, lipomyelomeningocele, split cord malformations, neuroenteric cyst) are often less severe and sometimes asymptomatic but may result in severe neurologic impairment secondary to spinal cord tethering. Modern health care facilities has resulted in a significant decrease in the mortality rate in patients with SB2 along with improved survival rate up to 80%. Due to the neurologic complexity and severity of these conditions, it is paramount to understand the challenges and offer the best anesthetic approach for these patients. To the best of our knowledge, this is the first case of SB going under caesarean delivery in our hospital. We wish to highlight our experience of perioperative management of this patient. Key words: Spina bifida, anesthetic management Citation: Lal S, Aisa T, Akram U, Sher A, Memon Z, Moriarty RM. Anesthetic management of cesarean section of a wheelchair bound parturient with myelomeningocele. Anaesth. pain intensive care 2020;24(5): Received: 13 June 2020, Reviewed: 24 June 2020, Revised: 18 July 2020, Accepted: 8 August 2020

Spina bifida occulta and monozygotic twins

2008 ◽  
Vol 2 (4) ◽  
pp. 258-260 ◽  
Author(s):  
Barbara Spacca ◽  
Neil Buxton
Keyword(s):  
Central Nervous System ◽  
Spina Bifida ◽  
Congenital Malformations ◽  
Genetic Basis ◽  
Monozygotic Twins ◽  
Tethered Cord ◽  
The Other ◽  
Spina Bifida Occulta ◽  
The Brain ◽  
Second Twin

Central nervous system maldevelopment can have different presentations in twins. We report on a case of different presentations of spina bifida occulta in monozygotic twins. The first twin presented at birth with a lipomyelomeningocele; a tethered cord was diagnosed in the second twin at 2 years of age. Neural tube defects (NTDs) are a group of common congenital malformations of the brain and spine generated during neurulation. The genetic basis of this process is still not well known. Whenever an NTD is diagnosed in one of a pair of twins, the other twin should also be evaluated for NTDs.

scholarly journals Outcome of surgical untethering of tethered cord syndrome in adults due to spina bifida occulta

2019 ◽  
Vol 15 (1) ◽  
pp. 68-74
Author(s):  
Bassam Mahmood Flamerz Arkawazi
Keyword(s):  
Spina Bifida ◽  
Lower Extremity ◽  
Tethered Cord ◽  
Adult Patients ◽  
Spina Bifida Occulta ◽  
Neurological Deficits ◽  
Neurological Injury ◽  
Early Surgery ◽  
Lower Extremity Weakness ◽  
Pain Status

Background:. Children with spina bifida occulta require early surgery to prevent neurological deficits. The treatment of patients with a congenitally tethered cord who present in adulthood remains controversial. Objective: The aim of this study is to describe the outcome obtained in 61 adult patients with congenital TCS and no prior surgical treatment who underwent surgical untethering. Methods: This prospective study was conducted on 61 adult patients who underwent surgical untethering for spina bifida occulta at four neurosurgical centers in Baghdad / Iraq  between March 2000 and January 2018. Patients who had undergone prior myelomeningocele repair or tethered cord release surgery were excluded. The most common intraoperative findings were lipomyelomeningocele (41%) and a tight terminal filum (36%). The follow-up duration ranged from 10.8 to 149.5 months (mean 20.9 months). Of the 34 patients with back pain, status improved in 65%, worsened in 3%, remained unchanged in 18%, and improved and later recurred in 15%. Lower-extremity pain improved in 16 patients (53%), remained unchanged in 23%, improved and then recurred in 17%, and worsened in 7%. Lower-extremity weakness improved in 47%, remained unchanged in 47%, and improved and then recurred in 5%. Finally, of the 17 patients with lower-extremity sensory changes, status improved in 35%, remained unchanged in 35%, and the information on five patients was unavailable. Surgical complications included three wound infections, one cerebrospinal fluid leak, and two pseudomeningoceles requiring surgical revision. One patient developed acute respiratory distress syndrome and sepsis postoperatively and died several days later. Conclusions: Adult-age presentation of a congenital tethered cord is unusual. Despite a slight increase in postoperative neurological injury in adults, surgery has relatively low risk and offers good potential for neurological improvement or stabilization. As in children, we recommend early surgery in adults with this disorder. The decision to undertake surgery, however, should be modulated by other factors such as a patient’s general medical condition and risk posed by anesthesia.

Tethered cord due to spina bifida occulta presenting in adulthood: a tricenter review of 61 patients

2007 ◽  
Vol 6 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Sharad Rajpal ◽  
R. Shane Tubbs ◽  
Timothy George ◽  
W. Jerry Oakes ◽  
Herbert E. Fuchs ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Lower Extremity ◽  
Medical Condition ◽  
Tethered Cord ◽  
Spina Bifida Occulta ◽  
Neurological Deficits ◽  
Neurological Injury ◽  
Early Surgery ◽  
Lower Extremity Weakness ◽  
Pain Status

Object Children with spina bifida occulta require early surgery to prevent neurological deficits. The treatment of patients with a congenitally tethered cord who present in adulthood remains controversial. Methods The authors studied the medical records of 61 adult patients who underwent surgical untethering for spina bifida occulta at three institutions between 1994 and 2003. Patients who had undergone prior myelomeningocele repair or tethered cord release surgery were excluded. The most common intraoperative findings were lipomyelomeningocele (41%) and a tight terminal filum (36%). The follow-up duration ranged from 10.8 to 149.5 months. Of the 34 patients with back pain, status improved in 65%, worsened in 3%, remained unchanged in 18%, and improved and later recurred in 15%. Lower-extremity pain improved in 16 patients (53%), remained unchanged in 23%, improved and then recurred in 17%, and worsened in 7%. Lower-extremity weakness improved in 47%, remained unchanged in 47%, and improved and then recurred in 5%. Finally, of the 17 patients with lower-extremity sensory changes, status improved in 35%, remained unchanged in 35%, and the information on five patients was unavailable. Surgical complications included three wound infections, one cerebrospinal fluid leak, and two pseudomeningoceles requiring surgical revision. One patient developed acute respiratory distress syndrome and sepsis postoperatively and died several days later. Conclusions Adult-age presentation of a congenital tethered cord is unusual. Despite a slight increase in postoperative neurological injury in adults, surgery has relatively low risk and offers good potential for neurological improvement or stabilization. As they do in children, the authors recommend early surgery in adults with this disorder. The decision to undertake surgery, however, should be modulated by other factors such as a patient's general medical condition and risk posed by anesthesia.

Tethered Cord Syndrome in Spina Bifida Occulta: A Case Report

1988 ◽  
Vol 11 (2) ◽  
pp. 121
Author(s):  
Ki Hong Choi ◽  
Chung Nam Kang ◽  
Jin Man Wang ◽  
Kwon Jae Roh ◽  
Young Hun Kim
Keyword(s):  
Case Report ◽  
Spina Bifida ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Spina Bifida Occulta

The tethered cord syndrome in adults with spina bifida occulta

2004 ◽  
Vol 26 (7) ◽  
pp. 735-740 ◽  
Author(s):  
Samir B. Lapsiwala ◽  
Bermans J. Iskandar
Keyword(s):  
Spina Bifida ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Spina Bifida Occulta

PP09.14 – 2843: Congenital absence of gluteal muscles without spina bifida occulta: The first case report

2015 ◽  
Vol 19 ◽  
pp. S68-S69
Author(s):  
G. Vigo ◽  
I. Toldo ◽  
D. De Grandis ◽  
V. Beltrame ◽  
S. Sartori ◽  
...  
Keyword(s):  
Case Report ◽  
Spina Bifida ◽  
Spina Bifida Occulta ◽  
Congenital Absence ◽  
First Case

ETHNOVETERINARY MEDICINAL USES OF SOME MEDICINAL PLANTS ON PNEUMONIA BY THE GUJJAR AND PAHARI TRIBES OF POONCH DISTRICT OF JAMMU AND KASHMIR

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
JAMIL AHMED KHAN ◽  
RAJINDER PAUL
Keyword(s):  
Health Care ◽  
Medicinal Plants ◽  
Medicinal Plant ◽  
Natural Resources ◽  
Indigenous People ◽  
Health Care Facilities ◽  
Jammu And Kashmir ◽  
Medicinal Uses ◽  
Modern Health Care ◽  
Care Facilities

Poonch district of Jammu and Kashmir is a reservoir of enormous natural resources including the wealth of medicinal plants. The present paper deals with 12 medicinal plant species belonging to 8 genera of angiosperms used on pneumonia in cattle such as cows, sheep, goats and buffaloes in different areas of Poonch district. Due to poverty and nonavailability of modern health care facilities, the indigenous people of the area partially or fully depend on surrounding medicinal plants to cure the different ailments of their cattles. Further research on modern scientific line is necessary to improve their efficacy, safety and validation of the traditional knowledge.

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