Neurowetenschappen
NTDs are abnormalities that can occur in the brain, spinal cord, or spine of a developing fetus.
Very early in the development of a fetus, certain cells form a tube (called the neural tube) that later becomes the spinal cord, brain, and nearby structures that protect them, including the spine (also called the spine or vertebrae). ). As development progresses, the top of the tube becomes the brain and the rest becomes the spinal cord. An NTD occurs when this tube doesn't completely close somewhere along its length, resulting in a hole in the spine or some other kind of problem.
These abnormalities occur in the first month of pregnancy, often before a woman even knows she is pregnant. Since they are present at birth, they are categorized as birth defects.
There are different types of NTDs, which are described here.
Spina Bifida
Spina bifida (pronounced SPY-nuh BIF-i-duh ) is the most common type of NTD. It occurs when the neural tube does not close completely. A baby born with spina bifida usually has paralysis of the nerves under the affected part of the spinal cord, which can cause lifelong walking and other problems. Since bladder and bowel functions are controlled by the lower spinal nerves, bowel and urinary tract disorders are common with spina bifida. Many babies with spina bifida have normal intelligence, but some will have learning disabilities or learning disabilities. 1 There are several common types of spina bifida:
- Spina bifida occulta (pronounced o-CULT-tuh ) is the mildest form. In fact, it's so mild that most experts don't consider it a true NTD. In this condition, there is a small opening in the spine but no opening or pocket on the back. The nerves and spinal cord are not damaged, and the defect usually does not cause disability. That is why spina bifida occulta is sometimes called "hidden" spina bifida. 2
- Closed neural tube defect is a malformation of the fat, bone, or membranes in the spine. In some people, closed NTD causes little or no symptoms, but other people may experience partial paralysis or other symptoms. In some cases, the only outward sign of closed NTD is a dimple or tuft of hair on the spine. 3
- Meningocele (pronounced muh-NING-guh-seel ) describes cases where a fluid bag pokes through an opening in the back, but the spinal cord is uninvolved or damaged. For this reason, some people with meningocele will not have any symptoms, while some people will have more serious problems. 2
- Myelomeningocele (pronounced MY-uh-low-muh-NING-guh-seel ) is the most severe and also the most common form of spina bifida. In this condition, the bones of the spine do not fully form, causing part of the spinal cord and the tissues covering the spinal cord to protrude from an opening in the back. A person with this condition usually has partial or complete paralysis in the parts of the body below the spine problem. Bowel and urinary problems are common. Children with myelomeningocele can also develop hydrocephalus (pronounced hahy-druh-SEF-uh-luhs ) (excess fluid in the brain), which can lead to learning and learning disabilities. Some babies born with myelomeningocele have severe intellectual disabilities.
Anencephaly
Anencephaly (pronounced an-en-SEF-uh-lee ) is a more serious but less common type of NTD. This condition occurs when the neural tube at the top does not close. As a result, most or all of the brain is missing and parts of the skull may be missing as well. Babies born with this condition usually remain unconscious and are deaf, blind, and unable to feel pain because brain structures related to those functions do not exist. They can have reflex actions such as breathing and responding to touch. Babies with anencephaly are either stillborn or die shortly after birth.
Encephalocele
Encephalocele (pronounced ehn-SEF-o-low-seel ), another rare type of NTD, occurs when the tube doesn't close close to the brain and there is an opening in the skull. The brain and membranes covering it can pass through the vaginal stick and form a pocket-like bulge. In some cases, there is only a small opening in the nasal cavity or forehead that is not noticeable. Babies with encephalocele may have other problems such as hydrocephalus, limb paralysis, developmental delay, intellectual disabilities, seizures, vision problems, a small head, facial and skull abnormalities, and uncoordinated movements (ataxia). Despite the various disabilities and developmental effects, some children with this condition have normal intelligence.
Ignorance
Iniencephaly (pronounced in-ee-ehn-SEF-ah-lee ), another rare but serious type of NTD, describes a head that is severely tilted back. The spine is exceptionally deformed. Often the child is missing a neck, with the skin of the face connected to the chest and the scalp to the back. Other abnormalities can also occur, such as cleft lip and palate, cardiovascular irregularities, anencephaly and malformed intestines. Babies born with this condition usually don't live longer than a few hours.
Symptoms
The symptoms associated with NTDs vary depending on the specific type of defect.
Symptoms include physical problems (such as paralysis and urinary and bowel control problems), blindness, deafness, intellectual disability, lack of consciousness and, in some cases, death. Some people with NTDs don't have any symptoms. Most children with certain types of NTD die or experience a serious disability.
Therapy
The treatment for spina bifida depends on the severity of the condition and the presence of complications. For some people, treatment needs can change over time depending on the severity or complications of the condition. 1
- Open spina bifida. A baby with myelomeningocele, where the spinal cord is exposed, may have surgery to close the hole in the back before birth or within the first days of birth.
- Hydrocephalus. If a baby with spina bifida has hydrocephalus (excess fluid around the brain), a surgeon can implant a shunt - a small hollow tube to drain fluid - to reduce pressure on the brain. Treating hydrocephalus can prevent problems such as blindness.
- Encephaloceles. People with encephaloceles - sac-like bulges where the brain and surrounding membranes protrude through the skull - are sometimes treated with surgery. During surgery, the tissue bulge is placed back into the skull. Surgery can also help correct anomalies in the skull and face.
- Tied spinal cord. Surgery can separate the spinal cord from surrounding tissue. 1
- Paralysis and limitations in mobility. People with spina bifida use a variety of means of transportation, including braces, crutches, walkers and wheelchairs.
- Urinary tract infections and lack of bladder and bowel control. People with myelomeningocele often have nerve damage that prevents the bladder from emptying completely. This can cause urinary tract infections and kidney damage. Health care providers can address this problem by using a tube to completely empty the bladder. Medications, injections, and surgery can also help prevent accidental urine leakage and keep the kidneys and bladder working long-term.
There is no treatment for anencephaly or iniencephaly. 2 Babies with these conditions usually die shortly after birth.
The nervous system plays a role in almost every aspect of our health and wellness. It accompanies everyday activities such as waking up; automatic activities such as breathing; and complex processes such as thinking, reading, remembering and feeling emotions.
The nervous system controls:
- Brain growth and development
- Sensations (such as touch or hearing)
- Perception (the mental process of interpreting sensory information)
- Thoughts and emotions
- Learning and memory
- Movement, balance and coordination
- Sleep
- Healing and rehabilitation
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