Neural Tube Disorders

• Neural Tube Defects - birth defects of the brain, spine, or spinal cord. 
• anencephaly - Absence Of the cerebral hemispheres
• anencephaly - occurs when the upper end of the neural tube fails to close in early intrauterine life
• anencephaly - Elevated Level of AFP in the maternal serum or on amniocentesis and confirmed by a prenatal sonogram
• anencephaly - May have difficulty in labor because the underdeveloped head does not engage in cervix well
• anencephaly - Infant’s present in a breech position
• anencephaly - Cannot survive with this disorder because they have no cerebral function

  • But the respiratory and cardiac centers are located in the intact medulla, they may survive for several days after birth
• anencephaly - Parents are offered the option of abortion vs ethical issues
• microcephaly - brain growth is so slow that it falls more than three standard deviations below normal on growth charts
• microcephaly - Is cognitively challenged due to lack of functioning brain tissue
• microcephaly - Cause disorder in brain development associated with an intrauterine infection such as rubella, cytomegalovirus, ortoxoplasmosis
• microcephaly - Result severe malnutrition or anoxia in early infancy
• microcephaly - Prognosis depends on the extent of restriction of brain growth and in the cause
• craniosynostosis - normal brain growth but premature fusion of cranial sutures, which also causes decreased head circumference under microcephaly
• • With surgery, craniosynostosis can be relieved and brain growth will be normal
• spina bifida occulta - Occurs when the posterior laminae of the vertebrae fail to fuse
• spina bifida occulta - Most commonly at the fifth lumbar or first sacral level but may occur at any point along the spinal canal
• craniosynostosis - abnormally loses fontanelles and often show bossing if the forehead and signs of increased intracranial pressure similar to infants with hydrocephalus
• spina bifida occulta - May be noticeable as dimpling at the point of poor fusion; abnormal tufts of hair or discolored skin may be present
• Because of this usage, parents, when told that their child has a spina bifida occulta, may interpret this as meaning their child has an extremely serious disorder. Help clarify the degree of defect for them
• meningocele - Appears as a protruding mass, the size of an orange, at the center of the back
• meningocele - Occurs at the lumbar region, although it may be present anywhere along the spinal canal
• meningocele - Protrusion may be covered by a layer of skin or only clear dura mater
• meningocele - Meninges covering the spinal cord herniate through unformed vertebrae
• myelomeningocele - Spinal cord and the meninges protrude through the vertebrae the same as with a meningocele
• myelomeningocele - Spinal cord ends at the point, so motor and sensory function is absent 
• myelomeningocele - Child will have flaccidity and lack of sensation of the lower extremities and loss of bowel and bladder control
• myelomeningocele - Child will have flaccidity and lack of sensation of the lower extremities and loss of bowel and bladder control
• myelomeningocele - Legs are lax, and they do not move them; urine and stools continually dribble because of lack of sphincter control
• myelomeningocele - Legs are lax, and they do not move them; urine and stools continually dribble because of lack of sphincter control
• myelomeningocele - Have talipes (clubfoot) disorders and developmental hip dysplasia
• myelomeningocele - Have talipes (clubfoot) disorders and developmental hip dysplasia
• myelomeningocele - CT or ultrasound scan or MRI
• Hydrocephalus accompanies myelomeningocele because of the lack of an adequate subarachnoid membrane for CSF absorption
• encephalocele - Is a cranial meningocele or myelomeningocele
• encephalocele - occurs in the occipital area of the skull but may occur as a nasal or nasopharyngeal disorder. Are covered fully by skin, but they may be open or covered only by the dura
• encephalocele - Symptoms:

  • Neurologic problems
  • Hydrocephalus
  • Spastic quadriplegia
• Size of encephalocele - CSF is trapped in the protruding meninges or whether brain tissue could also be involved
• encephalocele - CT, MRI, or ultrasound will reveal the size of the skull disorder
• NTD – SIGNS AND SYMPTOMS

  1. Loss of bladder/bowel control
  2. Partial/complete lack of sensation
  3. Partial/complete paralysis of the legs
  4. Weakness of the hips, legs/feet of the NB