Managing Paediatric Hydrocephalus : The New Thinking

In 2006, data was collected on 303 babies who were diagnosed with anencephaly and were not terminated. Of those 303 babies, about 40% were born prematurely (before 37 weeks) and 4% beyond 42 weeks. Two-thirds of the mothers were either induced or had a planned cesarean section for those born at term. Polyhydramnios was present in 30% of the cases which accounted for 60% of those born prematurely. When delivered by cesarean section, 4% died during birth, 53% died within twenty-four hours, 30% lived up to five days, and 13% lived longer than six days. For vaginal births, 37% of babies died during birth when a doctor or midwife ruptured the amniotic bag, opposed to 18% if the amniotic bag ruptured naturally.

Growing up as a middle class resident, it was made clear to me that I was able to become something in society but was never told what. This left me to many interpretations that weren’t always the right choices. I was left to believe that I had all the opportunities in the world, but only to enter high school I realized that this was not true. Understanding the truth about society has motivated me to become a more narrow minded person as I strive to become a pediatric neurosurgeon. One thing that I like to take part in is watching Grey’s Anatomy. This show’s influential African American doctors how inspired to believe that black people are able to become something despite this being a television show. In my future, I plan on having a little more melanin in my series. I love the city that I am from, Chicago. It is shown in the news as a negative place or seen as “Chiraq”. Many times, people make judgement directed to me due to the fact that I express I am from Chicago. That is why I make it my job to try to change these stereotypes that were placed upon me. I try to demonstrate to other people that I have the same capabilities and intelligence as people who do not live in Chicago as well as students who think I am less of a person because I am African American.

If symptoms progress, patients should make an appointment with a surgeon to see about surgical options. Surgery is to stop any progression of changes in the anatomy within the brain and spinal cord. Surgery is supposed to ease or at least stabilize any symptoms. The surgery decompresses the cervicomedullary junction and restores the normal

A Glasgow Coma Score of 8 or less also is an indication that the patient will need to be intubated soon. Once the tube is placed the ventilation may be useful in controlling the intracranial pressure as an intervention. Hyperventilation is a method used to reduce the carbon dioxide concentration in the vessels causing vasoconstriction which lessens the amount of blood circulating in the brain resulting in a decreased ICP (Zink and McQuillan, 2005). According to Zink and McQuillan, this intervention should only be utilized 24 hours after the initial injury because cerebral blood flow is often reduced at this point and constricting the vessels more may cause ischemia to occur. While using this technique it is important to monitor oxygenation to the brain tissue to assure no irreparable damage is

Views today demonstrate a viable singleton fetus at 12 weeks 2 days. Fetal crown-rump length measures 59.2 mm. The best nuchal translucency measurement obtained was 1.8 mm, and the nasal bone was visualized as present. Fetal cardiac activity is visualized. Due to early gestational age, fetal anatomy was not assessed, but 4 extremities are noted. Amniotic fluid and placental location are visualized as normal within limitations of early gestational age. Adnexa are suboptimally seen. No notching is seen on the uterine artery Doppler’s.

Unlike other diseases, Spina Bifida is a disease that cannot be cured with a drug or surgery. There is not a current cure for Spina Bifida, but there are ways of making the symptoms more endurable. If the child has Myelomeningocele, soon after birth, the child will most likely need surgery. The baby is at high risk of infection, so according to Seattle Children's Hospital,”Because part of your baby's spinal cord area is exposed, your baby is at risk of getting an infection or having more damage to the spinal cord. To lessen the risk, our neurosurgeons will operate within your baby's first 24 to 48 hours of life” (“Myelomeningocele,”2016). The surgeon will cover the spinal cord and closes the muscles around the muscle cord. Lastly, they close the skin to cover the spine. If the baby has hydrocephalus, which is when there is too much cerebrospinal fluid in the head and a shunt may be required to drain the fluid (“Myelomeningocele,”2016). Since the child may have slight paralysis below the wound, the child may need physical therapy. The Seattle Children’s Hospital states, “Some may need aids like braces, crutches or wheelchairs”(“Myelomeningocele,”2016). This will help with the slight paralysis that the child may be experiencing. Lastly, the surgeon may be able to do a fetal surgery on the child. The surgery is usually done around the 24th week of pregnancy (“Myelomeningocele,”2016). Depending on what

Chiari malformation is defined as a series of malformations of the cerebellum and the skull. This is the result of many things, one is theorized to be premature births of infants.There are many other possible causes for this.Another is Hydrocephalus, or “water on the brain”, which is in reality an excess of cerebrospinal fluid, CSF around the skull. The history of this dates back to 1891, an Austrian pathologists by the name of Hans Chiari found a malformation of the brain. Doctor Chiari found the types I,III,and IV. He characterized the definition of the disorder as “ A series of malformations of the cerebellum/hindbrain and skull”. Years later, one of Chiari’s students Julius Arnold, expanded on the ideas Chiari had found. Chiari is named for both Hans Chiari and Julius Arnold.

Premature babies are particularly at risk of suffering brain injury or even death if HIE occurs after delivery (Brandon.) The most common causes of postpartum HIE include: Severe cardiac or pulmonary disease. Infections, including sepsis and meningitis, severe prematurity, Low neonatal blood pressure, Brain or skull trauma and congenital brain malformations. In some cases, there are no identifiable causes for infant HIE (Brandon.) The effects and causes of HIE before, during, and after pregnancy can be mild to severe. There can be good outcomes with heavy treatment, but if symptoms are ignored it can become a nightmare for the child and

Hydrocephalus is a medical condition in which there is excessive accumulation of cerebrospinal fluid (CSF) thus abnormal increase of Intracranial Pressure (ICP). Hydrocephalus could happen for adult and infants, but it is more common with infants. It affects one to two in every 1000 live births. And it is by far the leading cause of brain surgery for children in the US. The NIH website estimates 700,000 children and adults living with hydrocephalus, less than 20% were appropriately diagnosed. The medical costs for hydrocephalus are over $1 billion per year. Unfortunately, yet hydrocephalus treatment has not been significant improved for 50 years. We need better treatments, more positive long-term monitoring, and diagnostic tests which are

The second type of open neural tube defect is known as myelmeningocele. Myelmeningocele occurs when the spinal column end of the neural tube fails to close (Mitchell, 2005). This type of neural defect is more well-known by its common name, spina bifida. This is very similar to anencephaly because both have to do with an end of the of the hollow tube not closing correctly. As seen above, having an end of the neural tube not close correctly causes missing parts of the body at the point where the defect occurred. In a similar way, spina bifida causes missing skin and body portions at the spinal end of the neural tube. This missing portion usually occurs at the bottom end of the spinal cord, but it is also possible that the missing portion can

Few published reports are available concerning about the use of neuraxial anesthesia in pregnant NMO patients. Two case reports described the development of NMO following subarachnoid anesthesia, which raised the matter of possible causal relationship between the two [66,67]. However, on the base of available knowledge, it seems to be the sequence of tenses instead of a causal relationship, in which the ability to unmask neurological deficits is a confounding factor that could be used as a tool for early diagnosis [67].

Background Aqueductal stenosis is a known cause of hydrocephalus. The scope of this paper is to highlight the disease burden of hydrocephalus attributed to aqueductal stenosis which still remains unknown in our setting. Materials and Methods In a descriptive cross-sectional study, 258 records of patients diagnosed with hydrocephalus were analyzed after ethical approval from KNH-UON ethics and research committee. Patients with a diagnosis of hydrocephalus due to aqueductal stenosis were included in this study. Patients age, sex, mode of delivery, associated comorbidities, presenting complaints, neurosurgical intervention performed, Kafarnosky score were recorded. Data were divided into 2 sets based on the patient’s age i.e. whether < 1 year or > 12 years. Data were recorded on google data collection form and analyzed using Google spreadsheets.Results: Out of 258 cases of hydrocephalus, 52 had aqueductal stenosis. Male to female sex ratio for this condition was 3:2. There were 25 cases < 1year and 27 cases > 12 years old who were diagnosed with hydrocephalus due to aqueductal stenosis. Associated conditions were bilateral congenital talipes equinovarus, spina bifida, Arnold Chairi malformations, meningitis and HIV. The presenting complaints differed according to the age groups. Neurosurgical interventions included ETV in 21 cases, insertion of VP shunt and ETV were done in 3 cases

More than 2,400 suspected cases of microcephaly have been reported this year in 20 Brazilian states, compared with 147 cases last year. Doctors are investigating 29 related infant deaths.

bulging fontanelles (soft spots of the head) with or without enlargement of the head size

Baby Theresa is a very unique case. Theresa Ann Campo Pearson was an infant born in Florida 1992, with Anencephaly, which is where the two most important parts of the brain are missing, the cerebrum and cerebellum, as well as the top of the skull. Without these parts of the brain she would never have had higher brain functions or consciousness. However, there is still a brain stem connected so all the autonomic functions are still working, such as having a heart beat and breathing. Anencephaly is known as one of the worst congenital disorders, thus these cases are usually detected during pregnancy and aborted. If not aborted, half are stillborn or if born alive, they usually die within a few days. In