The three major NTDs are?
Encephalocele
Anencephaly
Spina bifida
Encephalocele is a malformation of what?
The skull
The majority of encephaloceles occur in the __ region of the brain, but they can alsooccur in the ___ area (forehead, nose, or eye socket)
occipital
frontal
With encephaloceles, a portion of the brain protrudes in ___
a sac
Children with encephaloceles often have? (4 things)
intellectual disability, hydrocephalus, spastic legs, and/or seizures
There are better outcomes for encephaloceles if?
no associated brain abnormalities, other physical abnormalities, frontal rather than occipital, typical head circumference, and less brain tissue in the sac
_____ is a more severe congenital malformation of the skull and brain
Anencephaly
In anencephaly, no neural development occurs above?
the brainstem
With anencephaly, about __ of these children are spontaneously aborted
Those who live rarely____
half
survive infancy
____ is the most common neural tube defect
Spina bifida
Spina bifida is a split of the ____
Vertebral arches
Spina bifida can be isolated to the ___ or occur with a ____ that may contain part of the _____
bone
protruding meningeal sac
spinal cord
____is the most common type of spina bifida and the most benign; hidden separation
Spina bifida occulta
What type of spina bifida features no visible abnormalities on their back; no protruding sac; no symptoms (about 10% of the population)
Spina bifida occulta
What type of spina bifida matches this description: “born with a visible abnormality on lower back such as a birthmark, tufts of hair, a dermal sinus, or lipoma; increased risk of meningitis and other infections; defects such as spinal cord being tethered or split can lead to neurological damage as the child grows, so surgery to correct should be performed early”
Occult spinal dysraphism (OSD)-
A meningocele is an exposed _____ covering the spinal cord; usually, there are no _____ because spinal cord is not ____
membraneous sac
symptoms
entrapped
A Meningomyelocele (myelomeningocele) is a?
sac with malformed spinal cord
Meningomyelocele (Myelomeningocele) is often referred to as _____
Spina bifida
Symptoms of Meningomyelocele (Myelomeningocele) include:
complete or partial paralysis,
sensory loss below level of spinal abnormality
Chiari type II malformation with hydrocephalus
Neurogenic bowel and bladder
Most Meningomyelocele (Myelomeningocele) are ___ and part of the spinal cord is visible as an ____
open
open sac
Individuals with Meningomyelocele (Myelomeningocele)Typically have ____ that may present as _______
brain abnormalities
learning disabilities
Meningomyelocele (Myelomeningocele) is called the
most complex congenital malformation compatible with life
NTD malformation occurs by how long after fertilization?
26 days after fertilization of the egg during neurulation (the first step in formation of CNS)
If part of the ______ does not close completely, an NTD results, and the spinal cord is malformed
neural groove
Options for prenatal diagnosis of NTD
Measure levels of alpha-fetoprotein in mother’s serum during 16th-18th week of pregnancy
Ultrasound
Amniocentesis
Primary Impairments in Children with Meningomyelocele
Brain abnormalities p. 456 Table 25-1 Cognitive impairments Neurological Impairments: Paralysis Loss of sensation Learning disabilities Chiari type II malformation with hydrocephalus Mobility impairment- (Table 25-2 p. 460) Cognitive impairments Seizure disorders Fine motor impairments Visual impairment