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DysraphismAka: Neural Tube Defect, Meningocele

Definitions
1. Dysraphism
  1. Incomplete raphe closure allows neural herniation
2. Meningocele
  1. Meningocele in both cranial and Spinal Dysraphism
  2. Meninges and spinal fluid herniate via defect
Types
1. Cranial Dysraphism (e.g. Encephalocele)
2. Spinal Dysraphism (e.g. spina bifida)
Pathophysiology
1. Neural tube fails to close in weeks 3-4 in-utero
Associated Conditions
1. Hydrocephalus
Labs: Prenatal Detection
1. Serum Alfa-fetoprotein (sAFP) increased
  1. Routinely tested at 16-18 weeks gestation
2. Amniotic fluid measurements
  1. Amniotic fluid acetylcholinesterase increased
  2. Amniotic Alfa-fetoprotein increased
Prevention
1. Folic Acid supplementation before conception
References
1. Goetz (1999) Neurology, Saunders, p. 515-16

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