Neuro

Dysraphism

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Dysraphism, Neural Tube Defect, Meningocele

  • Definitions
  1. Dysraphism
    1. Incomplete raphe closure allows neural Herniation
  2. Meningocele
    1. Meningocele in both cranial and Spinal Dysraphism
    2. Meninges and spinal fluid Herniate via defect
  • Types
  1. Cranial Dysraphism (e.g. Encephalocele)
  2. Spinal Dysraphism (e.g. Spina bifida)
  • Pathophysiology
  1. Neural tube fails to close in weeks 3-4 in-utero
  • Associated Conditions
  1. Hydrocephalus
  • Labs
  • Prenatal Detection
  1. Serum Alfa-fetoprotein (sAFP) increased
    1. Routinely tested at 16-18 weeks gestation
  2. Amniotic fluid measurements
    1. Amniotic fluid Acetylcholinesterase increased
    2. Amniotic Alfa-fetoprotein increased
  • Prevention
  1. Folic Acid supplementation before conception
  • References
  1. Goetz (1999) Neurology, Saunders, p. 515-16