OPTA 222 (Spina Bifida)
Pathophysiology
- occurs when neural tube around the spine does not fully close; spine doesn't properly form to protect spinal cord
- Hydrocephalus can often co occur with spina bifida secondary to disruption of the fluid surrounding the brain and spinal cord
- 3 types; myelomeningocele (sac with spinal cord), meningcele(sac without spinal cord), occulta (gap in spine no sac)
Cause
pregnacy related care; take folic acid, not overheating during pregnancy, stay away from certain medication
Characteristics
-Variable depending on the location of the lesion
-Motor and/or sensory compromise in the areas below the lesion (think similar to SCI)
-Possible cognitive delay
-Possible bowel and bladder involvement
Treatment for Spina Bafida
Surgery is performed if there is a protrusion
There is no cure
What is Hyrocephalus?
an abnormal buildup of cerebrospinal fluid in the ventricles (cavities) deep within the brain.
6 causes cause of Hydrocephalus?
congenital
-Inherited genetic abnormalities that block the flow of CSF
-Developmental disorders such as those associated with birth defects in the brain, spine, or spinal cord
-Complications of premature birth such as bleeding within the ventricles
-Infection during pregnancy such as rubella that can cause inflammation in the fetal brain tissue
Acquired
-Brain or spinal cord tumors
-Infections of the central nervous system such as bacterial meningitis
-Injury or stroke that causes bleeding in the brain
Is hydrocephalus a congenital or acquired condition?
Both
Symtoms of Hydrocephalus in infants?
-rapid increase in head size
-An unusually large head
-A bulge on the soft spot (fontanel) on the top of the head
-Vomiting
-Problems sucking or feeding
-Sleepiness
-Irritability
-Eyes that are fixed downward ("sun setting") or are not able to turn outward
-Seizures
symptoms of hydrocephalus in adults?
-Headache
-Blurred or double vision
-Nausea or vomiting
-Problems with balance
-Slowing or loss of developmental progress like walking or talking
-Vision problems
-Decline in school or job performance
-Poor coordination
-Loss of bladder control and/or frequent urination
-Difficulty remaining awake or waking up
-Sleepiness
-Irritability
-Changes in personality or cognition including memory loss
How is hydrocephalus diagnosed?
through a clinical neurological exam and by using brain imaging techniques and other tests based on age, symptoms, and known or suspected abnormalities in the brain or spinal cord.
How is hydrocephalus treated?
surgury
-A shunt (tube) is surgically inserted into the brain and connected to a flexible tube placed under the skin to drain the excess fluid into either the chest cavity or the abdomen so it can be absorbed by the body.
-Endoscopic Third Ventriculostomy (ETV) improves the flow of CSF out of the brain. A tiny hole is made at the bottom of the third ventricle and the CSF is diverted there to relieve pressure.
-Choroid plexus cauterization uses electric current to burn the CSF-producing tissue (i.e., the choroid plexus) in the lateral ventricles in the brain, so it produces less CSF.