ACRANIA-ANENcephaly COMPLEX,
Fetal, in which the skull base and facial bone structures develop and the skull bone structures do not develop, the brain tissue is sometimes not seen at all, and sometimes it is seen as a mass with a malformed structure. is a malformation. Anencephaly can be thought of as the final stage/result of peer, where the brain tissue deprived of the protection of the skull bone structure deteriorates, deforms and gradually shrinks.
SPINA BIFIDA,
It can be defined as the insufficiency and/or failure in the development and closure of the bone structures forming the posterior part of the canal through which the spinal cord passes in one or more of the vertebrae that make up the spine. There are two types.
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Occult (closed/latent) type spina bifida: It constitutes about 15% of spinal closure anomalies. It rarely causes neurological problems. In this anomaly, there is no soft tissue opening and skin tissue defect accompanying bone closure insufficiency. , lumbosacral skin lesions (80%), eg local hair growth, dimple, sinus, increased pigmentation and nevus, subcutaneous mass.
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Open type spina bifida:It constitutes approximately 85% of spinal closure anomalies. In addition to the bone defect, there is also a skin and soft tissue defect, and the neural elements in the spinal canal and their membranes protrude through the canal through the opening to form a cystic mass. It causes neurological problems at a rate higher than 90%.
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1. Simple meningocele: The appearance of a simple cystic sac filled with cerebrospinal fluid without neural elements.
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2. Myelocele: At the level of bone and soft tissue defect, neural tissue elements are exposed without skin protection.
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3. Myelomeningocele: Neural tissue elements and membranes are found in the cystic sac filled with cerebrospinal fluid that extends out of the skin at the level of the bone and soft tissue defect.
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4. Myeloschisis: There is a superficial location of neural elements that are not covered by membranes.
Open type spina bifida creates detectable findings in fetal detailed ultrasound examination (fetal malformation scan or anomaly scan) performed between 18-24 weeks in the prenatal period and intrauterine diagnosis is possible. The probability of detecting occult type spina bifida findings is low.
In the presence of open type spina bifida, the findings that can be detected in the fetus in ultrasound examination are as follows; bone defect and deformity are seen in the lumbar region. At this level, the meningocele or meningomyelocele sac may or may not be visible. In the presence of this problem in the lumbar region, the cerebrospinal fluid circulation is impaired and the skull shape resembles a lemon due to the negative pressure in the skull, the lemon finding, the thinning or disappearance of the cerebrospinal fluid-filled cavity called cisterna magna behind the cerebellum. The banana sign, which is seen with a banana-like shape, and the enlargement of the spaces in the brain where the cerebrospinal fluid called the ventricle is located, ventriculomegaly-hydrocephalus are the findings that can be detected.
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