Jan 29 20 Prevent errors when congenital anomalies heralded Posted by admin Prevent errors when congenital anomalies heralded
It is a case of encephalocele it is one of neural tube defect which result secondary to folic acid defeciency
Encephalocele may be isolated or associated with other neural tube defect eg. Myelocele, meningocele, meningomyelocele
Also encephalocele may associated with other cyst in other organs eg. Kidney >>Meckel Gruber syndrome
Proper administration of folic acid 3 months before pregnancy and during pregnancy and Early 4d Prenatal US are very helpuful to prevent this error
mariem abd el samee
does it affect normal brain structure or after exesion this baby will develop normally???
Early identification antinatally by maternal ultrasound and detection of associated problems as hydrocephalus to allow proper suitable post natal care (avoid vaginal delivery to avoid injury of herniated brain tissues, avoid any instrumentation applied to scalp during delivery as forceps, be ready for respiratory center problems or other neurological problem this baby may have and ensure delivery at teriary care center)
Multidisplinary care are required for those neonates including obestatric doctor to avoid any brain injury during labour and neonatologist for care of any associated neurological problems as apnnea, seizures, feeding difficulties and neurosurgery for early detection of sac tear and proper manage for it to avoid meningitis and determine the suitable approach more management of herniated brain and radiologist for neuroimaging to detect internal brain and spinal cord malformation in addition to peediatric neurologist, psychiatrist and physiotherapist for assessment and follow up of long term sequale
Family support is very important item in care of such neonates
Currently, the only effective treatment for encephaloceles is reparative surgery, generally performed during infancy. The extent to which it can be corrected depends on the location and size of the encephaloceles; however, large protrusions can be removed without causing major disability. Surgery repositions the bulging area back into the skull, removes the protrusions, and corrects the deformities, typically relieving pressure that can delay normal brain development. Occasionally, shunts are placed to drain excess cerebrospinal fluid from the brain.[citation needed
It is acase of encephalocele which is atype of neural tube defect .we can prevent it by giving folic acid to pregnant women especially in the 1st trimester .it may be associated with another cogenital anomalies so we should do 4d US during pregnancy and cranial and abdominal US after birth
Neural tube defect, encephalocele (life threatening condition)
Prevention :1ry by administration of folic acid for females in child bearing period
2ry by early intrauterine diagnosis and intervention if possible
Encephalocele, is a neural tube defect characterized by sac-like protrusions of the brain and the membranes that cover it through openings in the skull. These defects are caused by failure of the neural tube to close completely during fetal development. Encephaloceles cause a groove down the middle of the skull, or between the forehead and nose, or on the back side of the skull. The severity of encephalocele varies, depending on its location.
In some cases encephaloceles occur in association with other neurological conditions such as Dandy-Walker malformation or Chiari malformation.
Encephaloceles are more common in individuals who have a family history of neural tube defects such as spina bifida or have a genetic predisposition for developing neural tube defects.
It is most severe form of dysraphism and have poor prognosis
Spina pivida manefista, a type of neural tube defects which includes encephalocel, myelocel, menengiocel or compilation of all of them
Antinatal diagnosis is very important because such baby needs to be delivered in spescilazed center to receive such baby which could need respiratory support or urgent neonatal surgery
Antinatal folic acid is the only preventive measure in such cases
Full neurological examination is important in such case also full investigation to exclude associated congenital anomalies
Amal Gaber mohmed
This lesion is Liable for any trauma or infection so careful manipulation and dressing is very important till surgical treatment done
Amal Gaber mohmed
Ulcerative lesions could develop in such conditions also secondary bacterial infection could develop