Fact Sheet Anencephaly
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Ultrasound Evaluation of the Central Nervous System
Ultrasound Evaluation of the Ultrasound Evaluation of the Central Nervous System Central Nervous System ••CNSCNS malformations are the second most Mani Montazemi, RDMS frequent category of congenital anomaly, Director of Ultrasound Education & Quality Assurancee after congenital heart disease Baylor College of Medicine Division of Maternal-Fetal Medicine ••PoorPoor timing of the examination, rather than Department of Obstetrics and Gynecology Texas Children’s Hospital, Pavilion for Women poor sensitivity, can be an important factor Houston Texas & in failing to detect a CNS abnormality Clinical Instructor Thomas Jefferson University Hospital Radiology Department Fetal Head Philadelphia, Pennsylvania Fetal Head Central Nervous System Brain Development 9 -13 weeks Rhombencephalon 5th Menstrual Week •Gives rise to hindbrain •4th ventricle Arises from the posterior surface of the embryonic ectoderm Mesencephalon •Gives rise to midbrain A small groove is found along •Aqueduct the midline of the embryo and the edges of this groove fold over to form a neuro tube that Prosencephalon gives rise to the fetal spinal •Gives rise to forebrain rd cord and brain •Lateral & 3 ventricles Fetal Head Fetal Head Ventricular view Neural Tube Defects ••LateralLateral ventricles ••ChoroidChoroid plexus Group of malformations: Thalamic view • Anencephaly ••MidlineMidline falx •Anencephaly ••CavumCavum septiseptipellucidi pellucidi ••CephalocelesCephaloceles ••ThalamiThalami ••SpinaSpina bifida Cerebellar view ••CerebellumCerebellum ••CisternaCisterna magna Fetal -
Unusual Presentation of Congenital Dermal Sinus: Tethered Spinal Cord with Intradural Epidermoid and Dual Paramedian Cutaneous Ostia
Neurosurg Focus 33 (4):E5, 2012 Unusual presentation of congenital dermal sinus: tethered spinal cord with intradural epidermoid and dual paramedian cutaneous ostia Case report EFREM M. COX, M.D., KATHLeeN E. KNUDSON, M.D., SUNIL MANJILA, M.D., AND ALAN R. COHEN, M.D. Division of Pediatric Neurosurgery, Rainbow Babies and Children’s Hospital; and Department of Neurological Surgery, The Neurological Institute, University Hospitals Case Medical Center, Cleveland, Ohio The authors present the first report of spinal congenital dermal sinus with paramedian dual ostia leading to 2 intradural epidermoid cysts. This 7-year-old girl had a history of recurrent left paramedian lumbosacral subcutaneous abscesses, with no chemical or pyogenic meningitis. Admission MRI studies demonstrated bilateral lumbar dermal sinus tracts and a tethered spinal cord. At surgery to release the tethered spinal cord the authors encountered para- median dermal sinus tracts with dual ostia, as well as 2 intradural epidermoid cysts that were not readily apparent on MRI studies. Congenital dermal sinus should be considered in the differential diagnosis of lumbar subcutaneous abscesses, even if the neurocutaneous signatures are located off the midline. (http://thejns.org/doi/abs/10.3171/2012.8.FOCUS12226) KEY WORDS • tethered spinal cord • epidermoid cyst • neural tube defect • congenital dermal sinus • dual ostia ONGENITAL dermal sinus tracts of the spine are a Spinal congenital epidermoid cysts arise from epi- rare form of spinal dysraphism, and are hypoth- thelial inclusion -
Facts About Spina Bifida 1995-2009 Bifida 1995-2009
Facts about Spina Facts about Spina Bifida 1995-2009 Bifida 1995-2009 January 9, 2012 Definition and Types United States Estimates Spina Bifida is a type of neural tube defect where the Each year, about 1,500 babies are born with Spina Bifida in spine does not form properly within the first month of the U.S. The lifetime medical cost associated with caring for pregnancy. There are three types of Spina Bifida: Oc- a child that has been diagnosed with Spina Bifida is estimated 4 culta, Meningocele, and Myelomeningocele. at $460,923 in 2009. Occulta, the mildest form, occurs when there is a In 1992, the Centers for Disease Control and Prevention division between the vertebrae. However, the spi- (CDC) recommended that women of childbearing age con- nal cord does not protrude through the back. The sume 400 micrograms of synthetic folic acid daily. Subse- spinal cord and the nerve usually are normal. This quently, the Food and Drug Administration (FDA) required type of spina bifida usually does not cause any dis- the addition of folate to enriched cereal-grain products by abilities. January 1998. Since then, the incident rate for Spina Bifida of . Meningocele, the least common form, occurs when post-fortification (1998-2006) was 3.68 cases per 10,000 live the covering for the spinal cord but not the spinal births, declined 31% from the pre-fortification (1995-1996) cord protrudes through the back. There is usually rate of 5.04 cases per 10,000 live births.4 little or no nerve damage. This type of spina bifida can cause minor disabilities. -
A Anencephaly
Glossary of Birth Anomaly Terms: A Anencephaly: A deadly birth anomaly where most of the brain and skull did not form. Anomaly: Any part of the body or chromosomes that has an unusual or irregular structure. Aortic valve stenosis: The aortic valve controls the flow of blood from the left ventricle of the heart to the aorta, which takes the blood to the rest of the body. If there is stenosis of this valve, the valve has space for blood to flow through, but it is too narrow. Atresia: Lack of an opening where there should be one. Atrial septal defect: An opening in the wall (septum) that separates the left and right top chambers (atria) of the heart. A hole can vary in size and may close on its own or may require surgery. Atrioventricular septal defect (endocardial cushion defect): A defect in both the lower portion of the atrial septum and the upper portion of the ventricular septum. Together, these defects make a large opening (canal) in the middle part of the heart. Aniridia (an-i-rid-e-a): An eye anomaly where the colored part of the eye (called the iris) is partly or totally missing. It usually affects both eyes. Other parts of the eye can also be formed incorrectly. The effects on children’s ability to see can range from mild problems to blindness. To learn more about aniridia, go to the U.S. National Library of Medicine website. Anophthalmia/microphthalmia (an-oph-thal-mia/mi-croph-thal-mia): Birth anomalies of the eyes. In anophthalmia, a baby is born without one or both eyes. -
Maternal Vitamin B12 Status and Risk of Neural Tube Defects in a Population with High Neural Tube Defect Prevalence and No Folic Acid Fortification Anne M
Maternal Vitamin B12 Status and Risk of Neural Tube Defects in a Population With High Neural Tube Defect Prevalence and No Folic Acid Fortification Anne M. Molloy, Peadar N. Kirke, James F. Troendle, Helen Burke, Marie Sutton, Lawrence C. Brody, John M. Scott and James L. Mills Pediatrics 2009;123;917-923 DOI: 10.1542/peds.2008-1173 The online version of this article, along with updated information and services, is located on the World Wide Web at: http://www.pediatrics.org/cgi/content/full/123/3/917 PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2009 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275. Downloaded from www.pediatrics.org. Provided by Trinity Health Sciences Centre on November 4, 2009 ARTICLE Maternal Vitamin B12 Status and Risk of Neural Tube Defects in a Population With High Neural Tube Defect Prevalence and No Folic Acid Fortification Anne M. Molloy, PhDa, Peadar N. Kirke, FFPHMIb, James F. Troendle, PhDc, Helen Burke, BSocScb, Marie Sutton, MB, MPHb, Lawrence C. Brody, PhDd, John M. Scott, ScDe, James L. Mills, MD, MSc Schools of aMedicine and eImmunology and Biochemistry and Immunology, Trinity College, Dublin, Ireland; bChild Health Epidemiology Unit, Health Research Board, Dublin, Ireland; cDivision of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; dMolecular Pathogenesis Section, Genome Technology Branch, National Human Genome Research Institute, Bethesda, Maryland The authors have indicated they have no financial relationships relevant to this article to disclose. -
Pushing the Limits of Prenatal Ultrasound: a Case of Dorsal Dermal Sinus Associated with an Overt Arnold–Chiari Malformation and a 3Q Duplication
reproductive medicine Case Report Pushing the Limits of Prenatal Ultrasound: A Case of Dorsal Dermal Sinus Associated with an Overt Arnold–Chiari Malformation and a 3q Duplication Olivier Leroij 1, Lennart Van der Veeken 2,*, Bettina Blaumeiser 3 and Katrien Janssens 3 1 Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; [email protected] 2 Department of Obstetrics and Gynaecology, University Hospital Antwerp, 2650 Edegem, Belgium 3 Department of Medical Genetics, University Hospital and University of Antwerp, 2650 Edegem, Belgium; [email protected] (B.B.); [email protected] (K.J.) * Correspondence: [email protected] Abstract: We present a case of a fetus with cranial abnormalities typical of open spina bifida but with an intact spine shown on both ultrasound and fetal MRI. Expert ultrasound examination revealed a very small tract between the spine and the skin, and a postmortem examination confirmed the diagnosis of a dorsal dermal sinus. Genetic analysis found a mosaic 3q23q27 duplication in the form of a marker chromosome. This case emphasizes that meticulous prenatal ultrasound examination has the potential to diagnose even closed subtypes of neural tube defects. Furthermore, with cerebral anomalies suggesting a spina bifida, other imaging techniques together with genetic tests and measurement of alpha-fetoprotein in the amniotic fluid should be performed. Citation: Leroij, O.; Van der Veeken, Keywords: dorsal dermal sinus; Arnold–Chiari anomaly; 3q23q27 duplication; mosaic; marker chro- L.; Blaumeiser, B.; Janssens, K. mosome Pushing the Limits of Prenatal Ultrasound: A Case of Dorsal Dermal Sinus Associated with an Overt Arnold–Chiari Malformation and a 3q 1. -
Neural Tube Defects, Folic Acid and Methylation
Int. J. Environ. Res. Public Health 2013, 10, 4352-4389; doi:10.3390/ijerph10094352 OPEN ACCESS International Journal of Environmental Research and Public Health ISSN 1660-4601 www.mdpi.com/journal/ijerph Review Neural Tube Defects, Folic Acid and Methylation Apolline Imbard 1,2,*, Jean-François Benoist 1 and Henk J. Blom 2 1 Biochemistry-Hormonology Laboratory, Robert Debré Hospital, APHP, 48 bd Serrurier, Paris 75019, France; E-Mail: [email protected] 2 Metabolic Unit, Department of Clinical Chemistry, VU Free University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, The Netherlands; E-Mail: [email protected] * Author to whom correspondence should be addressed; E-Mail: [email protected]; Tel.: +33-1-4003-4722; Fax: +33-1-4003-4790. Received: 27 July 2013; in revised form: 30 August 2013 / Accepted: 3 September 2013 / Published: 17 September 2013 Abstract: Neural tube defects (NTDs) are common complex congenital malformations resulting from failure of the neural tube closure during embryogenesis. It is established that folic acid supplementation decreases the prevalence of NTDs, which has led to national public health policies regarding folic acid. To date, animal studies have not provided sufficient information to establish the metabolic and/or genomic mechanism(s) underlying human folic acid responsiveness in NTDs. However, several lines of evidence suggest that not only folates but also choline, B12 and methylation metabolisms are involved in NTDs. Decreased B12 vitamin and increased total choline or homocysteine in maternal blood have been shown to be associated with increased NTDs risk. Several polymorphisms of genes involved in these pathways have also been implicated in risk of development of NTDs. -
Encephalocele
Encephalocele An encephalocele (pronounced en-sef-a-lo-seal) is a rare birth defect affecting the brain. It is one type of neural tube defect. The neural tube What is it? is a channel that usually folds and closes during the first few weeks of pregnancy. Normally, it forms the brain and spinal cord. Neural tube defects occur when the neural tube does not close as a baby grows in the womb. Neural tube defects can range in size and occur anywhere along the neck or spine. An encephalocele is a sac-like projection of brain tissue and membranes outside the skull. Encephaloceles can be on any part of the head but often occur on the back of the skull, as pictured below. Encephalocele Image courtesy of the Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities Children with an encephalocele may have additional birth defects, such as hydrocephalus, microcephaly, seizures, developmental delay, intellectual disability, and problems with coordination or movement. Hydrocephalus is extra fluid around the brain and is also called “water on the brain.” Microcephaly is a small head size. About 375 babies in the United States are born with an encephalocele How common is it? each year. That’s about 1 in every 10,000 babies. The cause of encephaloceles is unknown in most babies. There may be many factors that cause it. Taking folic acid can decrease the chance of having a baby with neural tube defects. Women who want to become What causes it? pregnant or are pregnant should take folic acid every day. -
CONGENITAL ABNORMALITIES of the CENTRAL NERVOUS SYSTEM Christopher Verity, Helen Firth, Charles Ffrench-Constant *I3
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.74.suppl_1.i3 on 1 March 2003. Downloaded from CONGENITAL ABNORMALITIES OF THE CENTRAL NERVOUS SYSTEM Christopher Verity, Helen Firth, Charles ffrench-Constant *i3 J Neurol Neurosurg Psychiatry 2003;74(Suppl I):i3–i8 dvances in genetics and molecular biology have led to a better understanding of the control of central nervous system (CNS) development. It is possible to classify CNS abnormalities Aaccording to the developmental stages at which they occur, as is shown below. The careful assessment of patients with these abnormalities is important in order to provide an accurate prog- nosis and genetic counselling. c NORMAL DEVELOPMENT OF THE CNS Before we review the various abnormalities that can affect the CNS, a brief overview of the normal development of the CNS is appropriate. c Induction—After development of the three cell layers of the early embryo (ectoderm, mesoderm, and endoderm), the underlying mesoderm (the “inducer”) sends signals to a region of the ecto- derm (the “induced tissue”), instructing it to develop into neural tissue. c Neural tube formation—The neural ectoderm folds to form a tube, which runs for most of the length of the embryo. c Regionalisation and specification—Specification of different regions and individual cells within the neural tube occurs in both the rostral/caudal and dorsal/ventral axis. The three basic regions of copyright. the CNS (forebrain, midbrain, and hindbrain) develop at the rostral end of the tube, with the spinal cord more caudally. Within the developing spinal cord specification of the different popu- lations of neural precursors (neural crest, sensory neurones, interneurones, glial cells, and motor neurones) is observed in progressively more ventral locations. -
Chiari Type II Malformation: Past, Present, and Future
Neurosurg Focus 16 (2):Article 5, 2004, Click here to return to Table of Contents Chiari Type II malformation: past, present, and future KEVIN L. STEVENSON, M.D. Children’s Healthcare of Atlanta, Atlanta, Georgia Object. The Chiari Type II malformation (CM II) is a unique hindbrain herniation found only in patients with myelomeningocele and is the leading cause of death in these individuals younger than 2 years of age. Several theories exist as to its embryological evolution and recently new theories are emerging as to its treatment and possible preven- tion. A thorough understanding of the embryology, anatomy, symptomatology, and surgical treatment is necessary to care optimally for children with myelomeningocele and prevent significant morbidity and mortality. Methods. A review of the literature was used to summarize the clinically pertinent features of the CM II, with par- ticular attention to pitfalls in diagnosis and surgical treatment. Conclusions. Any child with CM II can present as a neurosurgical emergency. Expeditious and knowledgeable eval- uation and prompt surgical decompression of the hindbrain can prevent serious morbidity and mortality in the patient with myelomeningocele, especially those younger than 2 years old. Symptomatic CM II in the older child often pre- sents with more subtle findings but rarely in acute crisis. Understanding of CM II continues to change as innovative techniques are applied to this challenging patient population. KEY WORDS • Chiari Type II malformation • myelomeningocele • pediatric The CM II is uniquely associated with myelomeningo- four distinct forms of the malformation, including the cele and is found only in this population. Originally de- Type II malformation that he found exclusively in patients scribed by Hans Chiari in 1891, symptomatic CM II ac- with myelomeningocele. -
Surveillance for Anencephaly and Spina Bifida and the Impact of Prenatal Diagnosis —United States, 1985–1994
August 25, 1995 / Vol. 44 / No. SS-4 CDC Surveillance Summaries Surveillance for Anencephaly and Spina Bifida and the Impact of Prenatal Diagnosis —United States, 1985–1994 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention (CDC) Atlanta, Georgia 30333 The MMWR series of publications is published by the Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), Public Health Service, U.S. Depart- ment of Health and Human Services, Atlanta, GA 30333. SUGGESTED CITATION General: Centers for Disease Control and Prevention. CDC Surveillance Sum- maries, August 25, 1995. MMWR 1995;44(No. SS-4). Specific: [Author(s)]. [Title of particular article]. In: CDC Surveillance Sum- maries, August 25, 1995. MMWR 1995;44(No. SS-4):[inclusive page numbers]. Centers for Disease Control and Prevention .......................... David Satcher, M.D., Ph.D. Director The production of this report as an MMWR serial publication was coordinated in: Epidemiology Program Office.................................... Stephen B. Thacker, M.D., M.Sc. Director Richard A. Goodman, M.D., M.P.H. Editor, MMWR Series Scott F. Wetterhall, M.D., M.P.H. Associate Editor, CDC Surveillance Summaries Scientific Information and Communications Program CDC Surveillance Summaries ...................................... Suzanne M. Hewitt, M.P.A. Managing Editor Rachel J. Wilson Ava W. Navin, M.A. Project Editors Peter M. Jenkins Visual Information Specialist Use of trade names and commercial sources is for identification only and does not imply endorsement by the Public Health Service or the U.S. Department of Health and Human Services. Copies can be purchased from Superintendent of Documents, U.S. -
Massachusetts Birth Defects 2011-2012
Massachusetts Birth Defects 2011-2012 Massachusetts Birth Defects Monitoring Program Bureau of Family Health and Nutrition Massachusetts Department of Public Health May 2016 Charles D. Baker, Governor Karyn E. Polito, Lieutenant Governor Marylou Sudders, Secretary, Executive Office of Health and Human Services Monica Bharel, MD, MPH, Commissioner, Massachusetts Department of Public Health Ron Benham, Director, Bureau of Family Health and Nutrition, Acting Director, Massachusetts Center for Birth Defects Research and Prevention Acknowledgements This report was prepared by Rebecca Liberman and Cathleen Higgins, Massachusetts Center for Birth Defects Research and Prevention. We would like to thank the Massachusetts Center for Birth Defects Research and Prevention staff who contributed to this report, including: Marlene Anderka, Xiaoli Chen, Dominique Heinke, Angela Lin, and Gerlinde Munshi. Data in this report have been collected through the efforts of Center field staff, including: Roberta Aucoin, Mitcheka Jalali, Washa Liu, Daniel Sexton, Lori Tetrault and Ashley Tracey. We would like to acknowledge the following individuals and organizations for their time and commitment in supporting the Center: Lewis Holmes, MD, MassGeneral Hospital for Children Carol Louik, ScD, Slone Epidemiology Center, Boston University Allen Mitchell, MD, Slone Epidemiology Center, Boston University Martha Werler, ScD, Department of Epidemiology, Boston University School of Public Health Ed Doherty, March of Dimes Massachusetts Chapter Massachusetts Registry of