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Spina bifida occur when a portion of neural tube fail to close properly .
This lead to defect or absence of vertebral arches to do failure of
mesoderm to organize the defect.
CAUSES
▪ Specific is unknown.
▪ Multiple factors such as heredity and environment are thought to interact
to produce thesedefects.
▪ The following have been identified as causative factors:
I. low levels of maternal vitamins (B 9), including folic acid;
II. obesity
III. uncontrollable diabetes
IV. medication that interfere with folate metabolism
V. hyperthermia during pregnancy.
TYPES
SPINA BIFIDA
The symptomatic children usually present after 6-8 years of age with
any of the following: -
▪ Progressive deformity of foot
▪ Changein micturition pattern
▪ Alteration in gait
▪ Trophic ulcers on the toes and feet.
SPINA BIFIDA OCCULTA
The symptomsinclude
▪ Development of hydrocephalous- characterized by macrocephaly,
headache, vomiting, urinaryincontinence
▪ Spastic weakness of all four limbs
▪ An abnormally small sized head
▪ Uncoordinated musclemovements
▪ Delayed developmental milestones
▪ Vision problems
▪ Seizures
MENINGOCELE
▪ cystic sac of meninges with spinal tissue and CSF, which herniate
through a defect in the posterior vertebral arch.
▪ They are of two types:
1. Myelocele -opentype
2. Myelomeningocele – closed type
MYELOMENINGOCELE
▪ Primary diagnosis is done by clinical manifestations. X-Ray ,CT Scan, MRI, and
complete neurological assessment.
▪ Routine blood and urine examination
▪ Prenatal diagnosis can be done by amniocentesis and estimation of alpha
fetoprotein.
▪ Management of this condition can be done by surgical correction of the defect.
▪ Correction of musculoskeletal deformities and regulation of bowel and bladder
function.
▪ Additional supportive measure includes prevention of injury and infection of
the sac by appropriate positioning with sterile dressing.
▪ Monitor headcircumference
▪ Adequate nutrition
SPINA BIFIDA
Most common and least severe Least common and not very severe Most severe
No protrusions of tissue and spinal cord Only meninges are involved not the Spinal cord and surrounding meninges
spinal nerve are involved
At most people have tuft of hair, dimple Protrusion that includes the meninges Spinal cord and meninges protrude out
or birthmark and a sac containing (CSF) of the vertebrae held together by sac of
skin
Usually no symptms Hydrocephalus, Spastic weakness Loss of sensation, paralysis, bladder or
small sized head, Seizures bowel problem ,seizures, leg
Uncoordinated musclemovements deformities
Delayed developmentalmilestones
Vision problems,Seizures
LABORATORY AND DIAGNOSTIC TESTS