Neural Tube Defects

* occurs during the 30th day after fertilization
CAUSES
* poor nutrition- folic acid
* taking in anticonvulsants
TYPES
1. ANENCEPHALY
* abscence of major portion of the cerebral hemispheres.
MANIFESTATION
* blindness
* deafness
* unable to feel pain
* unconsciousness
2. MICROCEPHALY
* smaller head circumference
* low brain growth, 3x slower than normal
CAUSES
* maternal infection
* TORCHS
* alcoholism
* DM
MANIFESTATION
* neurologic deficits
* delayed speech
* seizures
* quadriplegia
* mental retardation
3. SPINA BIFIDA
* split spines
a. occulta
* hidden
MAIN PROBLEM
* failure of posterior lamina of your vertebrae to close.
* fifth lumbar/ first sacral
MANIFESTATION
* dimpling between lumbar and sacral
* tufts of hair
* incontinence
* paralysis
* abscence of skin sensation
* scoliosis
b. meningocele
* least common and only the meninges protrudes.
MANIFESTATION
* protruding mass
c. myelomeningocele
* protrusion of spine and meninges
* cystica
MANIFESTATION
* paralysis of lower extremity
* incontinence
* flaccid paralysis
* hydrocephalus
4. ENCEPHALOCELE
* cranium befidum
* occurs in cranium
* protrusion in cerebellum- cervical C1-C2
DIAGNOSTIC
* sonography
* fetoscopy
* aminocentesis
* alpha-fetoprotein
MANAGEMENT
* if occult there is no need for surgery the other type needs surgery
* REPARATIVE SURGERY
* best care began after birth
* C/S delivery

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