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Assessment of fetal brain abnormalities
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Spina bifida aperta, manifest form of spina bifida, is classified into four types: meningocele, myelomeningocele, myelocystocele, and myeloschisis. In myelomeningocele, the spinal cord and its protective covering (the meninges) protrude from an opening in the spine. In meningocele, the spinal cord develops normally but the meninges protrude from a spinal opening. The most common location of the malformations is the lumbar and sacral areas of the spinal cord. Chiari type II malformation and secondary hydrocephalus/ventriculomegaly are mostly, and scoliosis or kyphosis occasionally, associated with open spina bifida. Surface anatomy of the fetus and appearance of clubfoot, which occasionally manifests early in mid-gestation as a complication of spinal bifida, are easily demonstrable by using 3D ultrasound. The 3D ultrasound with maximum mode can demonstrate bony structure (Fig. 4) and is helpful to detect the spinal levels of lesion and to predict neurologic prognosis. Although most myelomeningoceles are demonstrated as a protruding swelling, fetal back appears flat in the type of myeloschisis; therefore, open spina bifida may be often overlooked. Because more than 80% of cases of open spina bifida are associated with ventriculomegaly due to Chiari type II malformation, demonstration of ventriculomegaly is usually the first observable sign leading to the detailed examination of spine and the subsequent diagnosis of spinal bifida.
Developmental Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James H. Tonsgard, Nikolas Mata-Machado
Anomalies of unknown origin: Cervical myelocystocele.Meningocele.
Common Tips on Communication
Published in Justin C Konje, Complete Revision Guide for MRCOG Part 3, 2020
There are four different types of spina bifida. These are myelomeningocele, meningocele, spina bifida occulta and closed spina bifida. (a) Myelomeningocele is the most severe type, and here the baby’s spinal canal remains open along several vertebrae in the back (portions of the backbone or spine), allowing the spinal cord and the membrane that surrounds it to push out and form a sac in the baby’s back. (b) Meningocele is the second type in which the membranes around the spinal cord (meninges) push out through a defect in the spine, but the spinal cord usually develops normally so that surgery can often be used to remove the membranes without damaging the nerves. (c) Spina bifida occulta – this is the most common and mildest type of spina bifida. Here one or more vertebrae are not formed properly, but the gap in the spine is very small. It does not usually cause any problems, and most people are unaware that they have it. (d) Closed spina bifida – this consists of a diverse group of defects, in which the spinal cord is marked by malformations of fat, bone or meninges. In most of those with closed spina bifida, there are few or no symptoms; however, in a few, the malformation causes incomplete paralysis with urinary and bowel dysfunction.
Diagnosis of central nervous system abnormalities: comparison of prenatal neurosonography and foetal magnetic resonance imaging findings
Published in Journal of Obstetrics and Gynaecology, 2022
Sureyya Saridas Demir, Erkan Cagliyan, Fatma Ceren Sarioglu, Handan Guleryuz, Sabahattin Altunyurt
Foetal MRI demonstrated corpus callosum anomalies with cerebellar hypoplasia in 3 cases and normal anatomic findings in 6 cases among 36 cases with suspicion of corpus callosum anomalies in foetal USG. Foetal MRI changed the diagnosis as diastematomyelia in one of the eight cases with neural tube defect with Chiari malformation type II. Foetal MRI reported one encephalocele with Chiari malformation type III in one case, and Chiari malformation type III in one case among four cases with a diagnosis of encephalocele in neurosonography. Myelomeningocele with hydrocephalus and Chiari malformation type III in one case, and Chiari malformation type II in one case were reported in MRI among four cases with suspicion of Myelomeningocele in foetal USG. Foetal MRI revealed additional information as meningocele with vermian hypoplasia in one of the three cases with a diagnosis of meningocele in neurosonography.
Orbital Cyst with Ependymal Differentiation Associated with Microphthalmia
Published in Fetal and Pediatric Pathology, 2022
Maria D. Garcia, Diva R. Salomao, Lilly H. Wagner
The findings in this case suggest a distinct maldevelopment of the eye different from the classic colobomatous cysts associated with microphthalmos. Magnetic resonance imaging demonstrated a well-defined cystic lesion in the anterior right orbit displacing a small globe and no connection to the posterior fossa, which factors against this being a meningo-encephalocele. There were no meningothelial cells on examination of the entire tissue specimen, which also distinguishes this cyst from a meningocele or meningoencephalocele. We hypothesize that the synaptophysin-appearing cells are related to the maldevelopment of the eye, which separates this diagnostically from a myelomeningocele.
A novel surgical technique for treatment of symptomatic Tarlov cysts
Published in British Journal of Neurosurgery, 2023
Kemal Yucesoy, Murat Yilmaz, Hulagu Kaptan, Ersin Ikizoglu, Mert Arslan, Serhat R. Erbayraktar
Since Tarlov published the sacral perineural cysts for the first time in 1938 in an autopsy study, many articles about sacral meningeal cysts have been published.6 There is no consensus on the concepts used in the definition and classification of spinal cystic lesions. Different concepts such as cyst, pouch, diverticulum, Tarlov perineural cysts, spinal nerve root perineural cysts, meingeal diverticulum, intrasacral meningocele in the sacral region are used. These lesions are different from classic meningocele or myelomeningocele. Nabors et al.7 developed a simple classification of spinal cysts (Table 1).