Spinal bifida cystica:This is the incomplete closure with the spinal cord or
meninges protruding in a sac. There are two types of spinal bifida cystica:- Myelomeningocele:The sac contains the spinal cord, CSF, and
meninges. This patient usually experiences neurologic dysfunction. - Meningocele:The sac contains CSF and meninges. This patient
rarely experiences neurologic dysfunction.
Anencephaly:Cerebral hemispheres of the brain and the top portion of
the skull. The brainstem is intact, enabling the infant to have cardiopul-
monary functions; however, the infant is likely to die of respiratory fail-
ure a few weeks after birth.
Encephalocele:Portions of the brain and meninges protrude in the sac.
This patient usually experiences neurologic dysfunction.
Signs and Symptoms
Spinal bifida occulta:- Tuft of hair in the lumbar or sacral area
- Depression in the lumbar or sacral area
- Hemangioma in the lumbar or sacral area
Spinal bifida cystica meningocele: - Presence of sac
Spinal bifida cystica myelomeningocele: - Presence of sac
- Bowel incontinence
- Bladder incontinence
- Hydrocephalus
- Spastic paralysis
- Club foot
- Knee contractures
- Curvature of the spine
- Arnold-Chiari malformation
Anencephaly: - The top portion of the skull is missing
Encephalocele: - Mental retardation
- Paralysis
- Hydrocephalus
Test Results
Alpha-fetoprotein (AFP): Measure the alpha-fetoprotein between 16 and
18 weeks of gestation.
Amniocentesis: Assess if alpha-fetoprotein is in amniotic fluid. This test
is performed if the alpha-fetoprotein test is abnormal.
Ultrasound: Assess if there is a neural tube defect or defect in the ventral
wall. This test is performed if the alpha-fetoprotein test is abnormal.CHAPTER 10/ Neurologic Conditions^213