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
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
Encephaloceles are rare birth defects associated with skull defects characterized by partial lacking of bone fusion leaving a gap through which a portion of the brain sticks out (protrudes).
Dandy–Walker malformation (DWM) encompasses cystic dilatation of the fourth ventricle, complete or partial agenesis of cerebella vermis and enlarged posterior fossa while Dandy–Walker variant (DWV) comprises cystic posterior mass with variable hypoplasia of the cerebella vermis and no enlargement of the posterior fossa.
Central nervous system defects include disorders caused by an imbalance of cerebrospinal fluid (as in hydrocephalus) and a range of disorders resulting from malformations of the neural tube during embryonic development (often called “neural tube defects”). These defects vary from mild to severely disabling.
Spina bifida is a birth defect where there is an incomplete closing of the backbone and membranes around the spinal cord. It is a developmental congenital anomaly
Encephaloceles are rare birth defects associated with skull defects characterized by partial lacking of bone fusion leaving a gap through which a portion of the brain sticks out (protrudes).
Dandy–Walker malformation (DWM) encompasses cystic dilatation of the fourth ventricle, complete or partial agenesis of cerebella vermis and enlarged posterior fossa while Dandy–Walker variant (DWV) comprises cystic posterior mass with variable hypoplasia of the cerebella vermis and no enlargement of the posterior fossa.
Central nervous system defects include disorders caused by an imbalance of cerebrospinal fluid (as in hydrocephalus) and a range of disorders resulting from malformations of the neural tube during embryonic development (often called “neural tube defects”). These defects vary from mild to severely disabling.
Spina bifida is a birth defect where there is an incomplete closing of the backbone and membranes around the spinal cord. It is a developmental congenital anomaly
FETAL CENTRAL NERVOUS SYSTEM ANAOMALIES PRESENTATIONkumarramalakshmi
various fetal cns anamolies described with ante nantal and postnatal imaging features of ultrasound, barium study CT and MRI in each entity with representative iamges
Central nervous Pathology by dr sadaf hussainDureSameen19
The central nervous system (CNS) comprises the brain and spinal cord and is the most complex organ system in the human body. The CNS differs from other organ systems in the variety of functions that it provides and in the localization of these functions to specialized areas of the CNS. The localization of specialized functions means that a relatively small, focal lesion in the CNS can produce a profound deficit, for example, loss of speech. This localization also results in the various populations of neurons within the CNS having unique capabilities and also unique vulnerabilities to disease. For example, Parkinson disease (PD) preferentially affects the neurons of the substantia nigra in the brain stem, while Alzheimer disease (AD) preferentially affects the neurons of the cerebral cortex.
Mechanical Ventilation Cheat Book for Internal Medicine ResidentsThe Medical Post
This short cheat book talks about basic concepts and physiology of artificial ventilation and also elaborates on point guided approach in maneuvering different modes of mechanical ventilation. Consider this as a basic overview and is intended for all internal medicine residents.
Salient features of the book are -
- The book provides a shortcut to understand and remember certain specific formulae and points you require to interpret the 12-lead ECG.
- Treatment protocols (in green boxes) for most of the important conditions are also included.
- View sample ECGs as you read along the topics.
- The content is explained in a very simple language to provide good conceptions, written from a student’s point of view.
- People can gain their belief in the book after going through sample ECGs which would be available at www.themedicalpost.net/ecg
- The book competes with the other books available in the market in simplicity, summaries, treatment protocols, live diagrams and regularly updated sample ECGs on the website.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
The hemodynamic and autonomic determinants of elevated blood pressure in obes...
Neural tube defects and Craniosynostosis
1. CNS – Neural Tube Defects and
Craniosynostosis
Dr. Kalpana Malla
MD Pediatrics
Manipal Teaching Hospital
Download more documents and slide shows on The Medical Post [ www.themedicalpost.net ]
3. CONGENITAL ANOMALIES
• Defects of Neuronal Migration –
Lissencephaly
Porencephaly
Schizencephaly
Holoprosencephaly
• Craniosynostosis
• Agenesis of Corpus Callosum
• Microcephaly
• Hydrocephalus
4. DYSPLASIA
Abnormal Organisation Of Cells In Tissue
MORPHOGENESIS
Poor Formation
Of Tissue From Unusual Forces On Breakdown Of
Begining Normal Tissue Normal Tissue
MALFORMATION DEFORMATION DISRUPTION
7. EMBRYOLOGY
A single sheet of cells – midline ectoderm
Ectodermal plate enlarges
Neural folds become elevated and fuse forming
Neural tube
Fusion occurs in cervical region and proceed
both caudally and cephalic, by secondary
neuralization
Cephalic completed by 23rd day
Caudally completed by 28th day
Thus neural tube formation completed by 4th
week
Nelson.
9. TYPES OF NTD
PRIMARY
-95% of all NTD
Primary failure of closure/disruption of NT
btw 18-28 days.
Eg. -Myelomeningocele
Encephalocele
Anencephaly
10. TYPES OF NTD
SECONDARY
-5% of all NTD.
Abnormal deve. of lower sacral seg. during
secondary neuralisation
• Skin is usually intact
• Involves lumbo sacral region
Eg. Spina Bifida Occulta Meningocele
11. Spina bifida occulta:
• Midline defect of vertebral bodies without
protrusion of spinal cord / meninges.
• Asymptomatic , usually of no consequence
• Presents as patch of hair, lipoma, dermal sinus
in low back – underlying spinal malf.
• Level - L5 & S1.
• May be associated with tethered cord.
• May present as recurrent meningitis – look for
dermal sinus.
12.
13. Meningocele
Sac + CSF + intact skin + No nervous
tissue + usually no hydrocephalus
-Small sac which increases on crying
- Usually no neurological abnormality
14. Meningocele
• Inv.-
• CT HEAD – r/o hydro
• MRI SPINE – R/O (i)Diastematomyelia – division of spinal
cord into two halves by projection of fibrocartilagenous or
bony septum from post vertebral body
(ii) Tethered cord – slender threadlike filum terminale
attached to coccyx conus here is below L2 instead L 1
• Treatment –
• Skin intact – surgery in infancy
• Skin lacerated – urgent treatment
• Look for recto vaginal fistula
15. Meningomyelocele
Sac + CSF + neural element + discontinuous skin +
hydroce(80%).
TYPE – 94% of all NTD - Lumbo sacral
- Area of well developed skin at periphery With
thin apex covered by glistening arachnoid
membrane
- Usually CSF oozing +
16. Meningomyelocele
• Check for reflexes, muscle power of LL. Check for
SPHINTER and ANAL reflexes
TREATMENT:
• SURGERY
• MULTIDIS. APPROACH
• Look for other anomalies
• Treat hydroceph, Club foot
• Bladder and bowel care
17. LOBERS CRITERIA 1972 - FOR
SELECTIVE SURGERY
SURGERY NOT DONE IF –
• Severe praplegia below L3 with bladder
paralysis
• Gross Hydrocephalus
• ASSOCIATED LIFE THREATENING GROSS CONG.
MALFORMATION.
18. LOBERS CRITERIA 1972 - FOR
SELECTIVE SURGERY
SURGERY NOT DONE IF –
• Kyphosis
• Associated gross congenital anomalies
• Very large lesions
• Infection of sac ormeningitis
20. ANENCEPHALY
• Failure of closure of rostral neuropore.
• Large defect of calvarium, meninges, scalp
associated with rudimentary brain.
• Cerebral hemisphere and cerebellum
usually absent
• Associated anomalies-
• In pregnancy – polyhydroamnios
• Die at birth or few days
• Etiology – genetic, environmental toxins,
nutrition
21. ENCEPHALOCELE
• Contains sac + cerebral cortex +
cerebellum + brain stem
• – OCCIPITAL region, Can also occur in
frontal or nasofrontal
• ↑ risk of arnold chiari or dandy walker
malformation
• ↑ risk of hydroceph.
• Visual problems, microcephaly, mental
retardation, seizures associated
features.
23. Alpha-fetoprotein screening
• Measures the level of AFP in mothers' blood
during pregnancy.
• Abnormal levels of AFP -
Open neural tube defects (ONTD)
Down syndrome
Other chromosomal abnormalities
Defects in the abdominal wall of the fetus
Twins - more than one fetus is making the
protein
24. Neural tube defects – prevention
Folic acid deficiency:
If previous history of NTD in family :
4mg – 1 month before preg. To 3 months
thereafter
Else for every other women of child bearing age :
0.4mg – 1 month before conception till 12 weeks
gestation.
25. Defects of Neuronal Migration
• Lissencephaly – absence of cerebral
convolution due to faulty
neuroblast migration
• Porencephaly – cysts or cavities
within the brain
26. Defects of Neuronal Migration
• Schizencephaly – uni or bilateral cleft
within cerebral hemisphere
• Holoprosencephaly – defective
cleavage of procencephalon – single
ventricle,absent falx,fused basal
ganglia
29. Plagiocephaly - coronal synostosis
- Fusion of either rt or lt side of the
coronal suture
-Causes the normal forehead and
the
brow to stop growing
-Produces flattening of the
forehead and the brow on the
affected side, with the forehead
tending to be excessively prominent
on the opposite side
30. SCAPHOCEPHALY/DOLICHOCEPHALY
Early closure or fusion of
the sagittal suture
Fusion causes a long,
narrow skull .Prominent
occiput and forehead
Usually only
craniosynstosis which
is relatively harmless
31. TRIGONOCEPHALY
Fusion of the metopic
(forehead) suture
Fusion result in a
prominent ridge running
down the forehead -looks
pointed, like a triangle,
with closely placed eyes
(hypotelorism).
32. • Turriencephaly – cone shaped head .
Fusion of coronal and speno frontal or fronto
ethmoid sutures.
• Brachycephaly – premature closure of coronal
suture expands skull parallel to coronal suture
, thus broadening of forehead with short AP
diameter. Eg – in many syndromes like Downs
33. TYPES OF CRANIOSYNOSTOSIS
Primary
• Closure of sutures due to abnormality of skull
development. Eg – genetics.
34. Secondary
• Occurs from failure of brain growth and
expansion. Therefore causing premature
fusion.
35. CLINICAL
• Palpation of suture reveals prominent bony
ridge.
• Fusion may be confirmed by x-ray skull
• Associated syndromes – Crouzon , Alperts,
Carpenter,
36. TREATMENT
• Premature fusion of single suture rarely
causes any neurological deficit . Thus, in this
situation the only indication is cosmetics.
• 2 or more suture fusion – more complications
eg. ↑ ICT, hydrocephalus,
optic atrophy, DNS, choanal atresia ---
operative surgery essential – craniectomy with
craniofacial correction.
37. • Usually good prognosis with non syndromic
infants……………
38. Thank you
Download more documents and slide shows on The Medical Post
[ www.themedicalpost.net ]
![CNS – Neural Tube Defects and
Craniosynostosis
Dr. Kalpana Malla
MD Pediatrics
Manipal Teaching Hospital
Download more documents and slide shows on The Medical Post [ www.themedicalpost.net ]](https://image.slidesharecdn.com/cns-ntdandcraniosynotosis-120105095354-phpapp02/85/Neural-tube-defects-and-Craniosynostosis-1-320.jpg)
