Spina Bifida Cystica with Myelomeningocele
Spina bifida cystic with myelomeningocele is the most severe form of spina bifida and, unfortunately, is the most common form of spina bifida. Spina bifida is a neural tube birth defect where the neural tube does not close properly during early fetal development. Neural tube closure is normally finished by day 28 post conception. The closed neural tube then forms the spinal cord and the vertebral column that protects the spinal cord. If the child has a defect due to hereditary factors, drug usage or other potential risk factors, closure of the neural tube will not be complete and there will be a hole in the vertebrae.
Myelomeningocele is when the protective membrane of the spinal cord and the spinal cord itself protrudes through the hole in the vertebral column. In the most severe forms of myelomeningocele the spinal cord protrudes from the spinal column and is not protected by the membrane. The spinal cord is completely exposed. In these cases, the danger of infection in the form of meningitis is great. Often paralysis is the result of myelomeningocele. When this form of spina bifida is detected, surgery is scheduled immediately after the birth of the child to try to correct the defect.
Chiari II malformation is a possible consequence of myelomeningocele. Chiari II malformation is when the brain stem and cerebellum drop down into the neck and spinal column. When this happens, the spinal cord is compressed, causing problems with almost every biological function, including breathing, swallowing, and upper body stiffness. In addition, this compression can lead to an even more serious condition called hydrocelphalus. Hydrocephalus results when the compression blocks the flow of cerebrospinal fluid and causes a buildup of fluid inside the brain. If this buildup is not drained and corrected, the child can be severely brain damaged. When hydrocephalus is detected, doctors will insert a shunt into the brain which allows the fluid to drain into the abdomen.
Children born with myelomeningocele usually have lifelong physical and mental disabilities. Often they will have difficulty with language and math, problems focusing on tasks and reading comprehension deficits. Physical problems are determined by where the cleft in the spine is located. The higher the cleft the more physically disabled the child. Everything below the cleft in the spine is affected by the defect. A child born with myelomeningocele must be under a doctor’s constant care and always be vigilant for the development of hydrocephalus and Chiari II malformation.
Excellent video about myelomeningocele and everything you need to know about it
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