Meningomyelocoele
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Meningomyelocoele is the most severe type of spina bifida where there is a cystic swelling over the spinal defect containing meninges, nerve roots, and spinal cord outside the vertebral canal. It occurs due to failure of closure of the neural tube during development. Clinical features include lower limb paralysis, bladder and bowel dysfunction, hydrocephalus, and Arnold-Chiari malformation in 95% of cases. Treatment involves closure of the defect soon after birth along with lifelong multidisciplinary care. One study found that children with meningomyelocoele who could walk, even with aids, performed better cognitively than those who used wheelchairs, suggesting locomotion may positively impact development.
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Meningomyelocoele is the most severe type of spina bifida where the meninges and spinal cord protrude through an opening in the spine. It occurs due to failure of the neural tube to close during the third week of gestation. Symptoms include paralysis of the lower limbs, bladder and bowel dysfunction, and cognitive impairments. Treatment requires multidisciplinary care and focuses on preventing infections, promoting urinary function, and managing complications through surgery, medications, bracing and rehabilitation.
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Meningomyelocoele is a severe type of spina bifida where the meninges, nerve roots, and spinal cord protrude through a defect in the spine. It occurs due to failure of the neural tube to close during early development. Children with meningomyelocoele often experience neurological deficits, paralysis, bladder and bowel issues, hydrocephalus, and other health problems. Treatment requires surgery after birth to close the defect, as well as lifelong multidisciplinary care and therapies to address complications. Improving mobility, even with aids, can positively impact cognitive development in children with meningomyelocoele compared to those who are wheelchair-dependent.
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Spinal dysraphism and its management
a comprehensive presentation on the subject of spinal dysraphism and spina bifida and its neurosurgical management as well as the management of its various other types
Birth defects
The document discusses various birth defects including:
1. Atavism, polydactyly, syndactyly, gigantism, and cleft lip which are abnormalities in development.
2. Terms used to describe diseases such as signs, symptoms, and etiology.
3. Types of anomalies including malformations, disruptions, deformations, and syndromes.
4. Various congenital defects and birth defects are discussed such as clubfoot, torticollis, Down syndrome, fetal alcohol syndrome, muscular dystrophy, spina bifida, and cerebral palsy. Environmental factors that can influence birth defects are also summarized.
Myelomeningeocele by Dr. Raheel Gohar.pptx
Myelomeningeocele is a topic of discussion for every neurosurgery resident.
It is presented frequently in meetings, this case is seen and dealt with in developing countries a lot.
This ppt is for students as well as for neurosurgery Residents.
Neurologic Causes Of Stransimus
Neurological causes of strabismus can include cranial nerve palsies, neurological diseases like myasthenia gravis and mitochondrial disorders, posterior fossa tumors/malformations, and increased intracranial pressure. The neurological examination and history regarding acute onset, head trauma, and other neurological signs can help identify neurological causes of strabismus, which sometimes require further testing like MRI to identify underlying conditions like tumors or hydrocephalus.
Mylomeningocele
Meningomyelocoele is the most severe type of spina bifida where the meninges and spinal cord protrude through an opening in the spine. It occurs due to failure of the neural tube to close during the third week of gestation. Symptoms include paralysis of the lower limbs, bladder and bowel dysfunction, and cognitive impairments. Treatment requires multidisciplinary care and focuses on preventing infections, promoting urinary function, and managing complications through surgery, medications, bracing and rehabilitation.
HYDROCEPHALUS presentation.docx
Hydrocephalus is a condition where excess cerebrospinal fluid accumulates in the brain's ventricles. It occurs in 3-4 per 1000 births and can be congenital or acquired. Common causes include malformations that obstruct cerebrospinal fluid flow or absorption. Clinical signs include head enlargement, bulging fontanels, vomiting, and irritability in infants. Diagnosis involves imaging tests to locate the obstruction. Treatment is usually surgical placement of a shunt to drain cerebrospinal fluid from the brain ventricles to the abdomen or heart. Post-operative care focuses on monitoring for increased intracranial pressure signs that could indicate shunt malfunction or infection.
Newborn examination
This document provides guidance on performing a newborn examination. It discusses examining the baby's history, vital signs, appearance, major body systems and reflexes. The examination is conducted in a warm, well-lit room and includes assessing temperature, heart rate, respiratory rate, blood pressure, color, muscle tone, reflexes, measurements and a full physical exam from head to toe. The exam evaluates the skin, fontanelles, eyes, ears, heart, lungs, abdomen, genitals, limbs and neurological function through assessing tone and primitive reflexes. The goal is to identify any abnormalities and ensure healthy development.
Clival Pathology.ppt
1) The document discusses various pathologies that can affect the clivus region, including congenital malformations, acquired conditions, and primary and secondary neoplasms.
2) Examples of discussed pathologies include proatlas segmentation failure, neuroenteric cysts, basilar invagination, fibrous dysplasia, chordoma, plasmacytoma, and meningioma.
3) The pathologies are described in terms of their etiology, clinical presentation, diagnostic evaluation, and treatment options.
Ntd
This document discusses neural tube defects (NTDs), which are birth defects where an opening remains in the spine or skull early in development. The main types are open defects like spina bifida and anencephaly, and closed defects. NTDs can be caused by folic acid deficiency, genetics, medications, and other factors. Symptoms vary depending on the specific defect. Diagnosis may involve ultrasounds and alpha-fetoprotein testing. Treatment ranges from surgery to palliative care, while prevention focuses on adequate folic acid intake before and during pregnancy.
Neural Tube Defects for Undergraduate Medical Students
Neural tube defects are congenital abnormalities that occur during early embryonic development caused by the neural tube failing to close properly. There are two types: open defects which result in exposed spinal cord or brain tissue, and closed defects where the spine and skull do not fully close. Risk factors include low folic acid intake, certain medications, diabetes, and obesity during pregnancy. Clinical features vary depending on the location and severity of the defect but may include paralysis, weakness, learning disabilities, vision problems, and bowel/bladder issues. Prenatal screening includes ultrasound and maternal serum alpha-fetoprotein levels. Treatment options include in utero surgery, conventional post-birth surgery, or endoscopic repair to close the opening.
Ataxia
This document discusses ataxia in children. It describes the different types of ataxia including sensory ataxia and cerebellar ataxia. It outlines the characteristic features, locations of lesions, physical exam findings, and hints to differentiate between sensory and cerebellar ataxia. The document also provides guidance on evaluating a child with ataxia including taking a thorough history, performing a full physical and neurological exam, ordering appropriate tests and imaging, and considering possible consultations. Common causes of ataxia in childhood are discussed such as congenital, degenerative/genetic, infectious, metabolic, neoplastic, toxic, traumatic and vascular etiologies.
Similar to Meningomyelocoele (20)
Neural Tube Defects for Undergraduate Medical Students
Neural Tube Defects for Undergraduate Medical Students
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CAD+And+ACS
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Cardiac+Electrophysiology
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Diabetes+and+Pregnancy
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Osteoid+Osteoma
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Osteoid+Osteoma
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Osteoid+Osteoma
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Osteoarthritis
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Meningomyelocoele
- 2. Introduction • Meningomyelocoele is the most severe type of SPINA BIFIDA. • Spina Bifida means "split spine” • 4 types of Spina Bifida are: – Spina bifida occulta, – Meningocele – Spina bifida cystica (Myelomeningocele) and – Lipomeningocele • Meningomyelocoele – occurs due to Failure of closure of the neural tube during the third week of gestation – abnormal differentiation of the embryonic neural tube • In Meningomyelocoele, a cystic swelling occurs over the site of the spinal defect which contains meninges, nerve roots, and the spinal cord itself which has left the vertebral canal
- 3. Spina bifida
- 4. Spinal Dysraphism Spina bifida occulta Meningocele Myelomeningocele
- 6. Incidence - Meningomyelocoele • 1-2/1000 live birth • Neural tube defects are second most common type of birth defect • Myelomeningocele is the most common form of neural tube defect. • Slightly higher in females than in males (1.2:1) • 85% occur in lumbosacral • region
- 7. Aetiology • Poor nutrition - Folic acid deficiency • Genetics (People of Northern European and Hungarian ancestry have the highest rates of the disease) • Chromosome abnormalities: – Trisomies 13 and 18 – Triploidy – Single gene mutations • Maternal obesity, hyperthermia • pregnancies complicated by diabetes at conception • Drugs: valproate, carbamazepine and drugs to induce ovulation • Maternal exposures to fumonisins, electromagnetic fields, hazardous waste sites, disinfection by-products found in drinking water and pesticides
- 8. Meningomyelocele – Clinical Features • Both meninges and spinal cord protrude into the skin of the back • Leak of cerebrospinal fluid (CSF) is common • Severe neurological deficits are common • Risk for bacterial meningitis • Paraplegia • Diminished control of lower limbs, bladder Hydrocephalus and bowel • Hydrocephalus often accompanies • Short stature and precocious puberty Paraplegia
- 9. Primary Functional System Congenital deficits Anomalies • Lower limb paralysis • Facial clefts • Sensory loss • Heart • Bladder and bowel malformations, and dysfunction • Genitourinary tract • Cognitive dysfunction anomalies • Cranial nerve • Urinary tract dysfunction anomalies – Ocular muscle palsies, – solitary kidney or – Swallowing andeating – malformed ureters problems and – Abnormal phonation
- 10. Arnold Chiari II in 95% of myelomeningocoele • Herniation of cerebella vermis through foramen Magnum (cerebella tonsils extend down into the spinal cord, lower CN run up instead of down) • Dislocation of the 4th ventricle towards neural canal • Associated with hydrocephalus 85% • Developmental abnormalities in CV, GI, GU systems 10%
- 11. DIAGNOSIS • Ultrasound during the second trimester • The diagnosis of myelomeningocele is certain when 3 classic central findings are present in ultrasonography – concavity of the frontal bones, – ventriculomegaly, and – Chiari II malformation. • Positive screening for maternal serum alpha-fetoprotein (AFP) • Screening of the amniotic fluid for AFP, as well as for the presence of acetylcholinesterase Ultra Sound Coronal view of spine Lemon" shaped skull Sagittal view of spine
- 12. Treatment • Intrauterine surgery • Post-natal surgery:- Closure of the Myelomeningocele is performed immediately after birth if external CSF leakage is present and typically within the first 24-48 hours in the absence of CSF leakage • Multidisciplinary interventions needed to prevent progressive deterioration of multiple body systems • Treatment team consists of pediatric specialists in – Physical medicine and rehabilitation – Neurosurgery – Urology – Orthopedics along with – Pediatric nursing – Physical therapy – occupational and recreational therapy – psychology and – medical social work
- 13. Medication • Anticholinergics: - to suppress detrusor overactivity eg. Oxybutynin chloride • Tricyclic antidepressants, eg. Imipramine hydrochloride • Alpha-adrenergic antagonists: - decrease bladder outlet resistance, increase urinary flow rate, and improve bladder emptying eg. Terazosin
- 14. Locomotion improves the cognitive profile of children with Meningomyelocele? • Twenty-nine children with MMC and shunted hydrocephalus were studied. • All had motor impairment, but after physiotherapy and training, walking was possible in 23 of them (5 autonomously and 18 with an aid), while 6 had recourse to a wheelchair. • Even though global I.Q. in these MMC children was within the normal range, the characteristic splitting between verbal I.Q. (VIQ) and performance I.Q. (PIQ) was observed, but the most interesting observation was a significant performance-related difference (P=0.044 and P=0.012) between ambulatory patients (both with and without aids) and those who were dependent on wheelchairs (PIQ: 83-85 vs 63). Reference: Rendeli C. et.al; Does locomotion improve the cognitive profile of children with meningomyelocele?; Child’s Nerv Syst (2002) 18:231–234