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Fetal malformations detected with magnetic resonance imaging in the diabetic mother
Published in Moshe Hod, Lois G. Jovanovic, Gian Carlo Di Renzo, Alberto de Leiva, Oded Langer, Textbook of Diabetes and Pregnancy, 2018
NTD is actually a broad variety of malformations related to failure of closure of neural tube. It can be categorized into open and closed defect. Common open NTD include rachischisis and myelomeningocele. Rachischisis is the most severe form of NTD and is invariably lethal. The absence of an extensive segment of vertebral column leads to a significant exposure of neural tissue. The more common form of open NTD is myelomeningocele. Open NTD, as shown in Figure 42.11, is almost always found with Arnold–Chiari type II malformation. This is a herniation of the brain stem, the cerebellar vermis, and the fourth ventricle through the foramen magnum due to loss of pressure from leakage of cerebrospinal fluid. The degree of cerebellar herniation is related to seizures, bladder dysfunction, and ambulation restriction.22 Cerebellum and other intracranial structures in the posterior fossa have limited visibility from standard ultrasound examination. MRI can yield more details in the posterior fossa due to its superb soft tissue contrast, as shown in Figure 42.12.23 Associated higher cerebral abnormalities, as a consequence of NTD, can also be clearly demonstrated with MRI, as shown in Figure 42.13.
Tumors of the spinal cord
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Homero Bruschini, J. Pindaro P. Plese, Miguel Srougi
Less common tumors are those derived from embryologic disorders, such as dermoid cysts, lipomas, teratomas, and neuroenteric cysts. They occur mainly in the lumbar and thoracolumbar areas. Other causes are malformations such as spina bifida and occult rachischisis. Some nonneoplastic lesions can simulate tumors, such as arachnoid cysts7 and dural inflammations such as sarcoidosis and tuberculosis.
The Spinal Cord and the Suboccipital Triangle
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
If the passage of the meninges through the bony defect is accompanied by the spinal cord or nerve roots, the herniating mass is called a meningomyelocele. Meningoceles and meningomyeloceles must be treated surgically. Rachischisis is a condition in which several or all vertebrae lack closure of the vertebral arches.
Underappreciated challenges to pediatric powered mobility – Ways to address them as illustrated by a case report
Published in Assistive Technology, 2018
Miriam L. Weinstein, Michele Lloyd, Kirstie A. Finch, Abbigayle D. Laszacs
We present a case of a 2 years 10 months old male with rachischisis, complete spina bifida without acrania, and Chiari II malformation with severe hydrocephalus. The condition, which carries a high risk factor for mortality, was diagnosed in utero. He was a term infant. Intraventricular shunt placement, closure of the spinal defect, and skin grafting were completed in the first few days of life. He was Gross Motor Functional Measure (GMFM) Level V: characterized by severe limitations in head and trunk control, and all areas of motor function, causing dependence on a manual wheelchair (Palisano et al., 1997). His physical therapy evaluation noted weakness of his neck and trunk muscles (3–5 seconds of control) and inability to sit independently. He had severe kyphoscoliosis and hip flexion contractures of −40 degrees.