Nervous

• Hydrocephalus


  Accumulation of excess CSF in the ventricles or subarachnoid space due to an imbalance of CSF absorption or production
• Hydrocephalus

  • Extraventricular - fluid able to reach the spinal cord
  • Obstructive or intraventricular - block to CSF circulation into the subarachnoid space
• Overproduction of CSF


  By the choroid plexus in the first or second ventricle
• Obstruction of CSF passage

  In the narrow aqueduct of Sylvius
• Interference with CSF absorption

  From the subarachnoid space
• Transillumination can reveal the skull is filled with fluid rather than solid brain tissue
• Ventriculoperitoneal (VP) shunt


  CSF drains into the peritoneal cavity from the lateral ventricle
• Atrioventricular (AV) shunt


  CSF drains into the right atrium of the heart from the lateral ventricle, bypassing the obstruction
• Neural Tube Defect


  Malformations of the neural tube
• Spina bifida


  A term for all spinal cord disorders

  
• Incidence of neural tube defects in the US reduced to 2 in 10,000 live births since inclusion of folic acid in prenatal vitamins and fortified foods
• All women, especially those with a previous child with a spinal cord disorder, should have maternal serum assay MAFP levels tested in a second pregnancy
• Anencephaly


  Severe defect involving absence of the cerebral hemispheres
• Microcephaly


  Fetal brain grows slowly, falling more than 3 standard deviations below normal at birth
• Spina Bifida Occulta


  Mildest form of neural tube defects, with non-closure or incomplete closure of the posterior vertebrae but meninges not exposed

  
• Spina Bifida Cystica


  Protrusion of the spinal cord and/or meninges, resulting in incomplete closure of the vertebral and neural tubes

  
• Meningocele


  Protrusion of meninges and CSF-filled sac, usually in the lumbosacral area, without nerve tissue involvement
• Myelomeningocele


  Protrusion of meninges, CSF, nerve roots, and portion of spinal cord, resulting in paralysis and loss of sensation and function

  
• Encephalocele


  Cranial meningocele, protrusion of meningeal and cerebral tissue through a defect in the skull, usually at the occiput

  
• Cerebral Palsy


  Disorder characterized by impaired movement and posture from abnormality in motor system
• Muscular Dystrophy


  Inherited disease causing muscle atrophy and weakness
• Muscular Dystrophy is an X-linked recessive disease that primarily affects males
• Duchenne's Muscular Dystrophy


  Most common form, appearing in early childhood until age 25