Pediatric Neurosurgery

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Syringomyelia

Syringomyelia is a chronic illness in which fluid-filled cysts called “syrinx” develop inside your spinal cord. Hydromyelia, syringohydromyelia, and Morvan illness are all names for the same condition. Syringomyelia is most frequent in individuals between the ages of 20 and 40, however it can affect anyone at any age. It is more common in men than in women.

Chiari Malformation

Chiari malformations are normally caused due to structural defects in the brain or spinal cord, these defects occur during the fetal development phases. But Chiari malformation can also occur in later stages of life. if there is any injury or exposure to toxic substances this can result in drainage of an excessive amount of cerebrospinal fluid, the fluid which protects the brain and spinal cord. Chiari malformation is considered a congenital condition, although acquired forms of the condition have been diagnosed. In the 1890s, a German pathologist, Professor Hans Chiari, first described abnormalities of the brain at the junction of the skull with the spine. He categorized these in order of severity; types I, II, III and IV. The term “Arnold-Chiari” was latter applied to the Chiari type II malformation. These malformations, along with syringomyelia and hydromyelia, two closely associated conditions, are described below. The cerebellum controls the coordination of motion and is normally located inside the base of the skull, in what is referred to as the posterior fossa. Usually, the cerebellum is composed of two lateral halves, or hemispheres, and a narrow central portion between these hemispheres, known as the vermis. Along the under surface of the hemispheres, there are two small protrusions called the tonsils. The fourth ventricle is a space filled with cerebrospinal fluid (CSF) located in front of the cerebellum (and behind the brainstem). All of these structures are located just above the foramen magnum, the largest opening at the base of the skull through which the spinal cord enters and connects to the brainstem.

Myelomeningocele

Spina bifida is a variable defect in which the vertebral arch of the spinal column is either incompletely formed or absent. The term Bifida is from the Latin word Bifidus, or “left in 2 parts.” It is classified as a defect of the neural tube (i.e. the embryonic structure that develops into the spinal cord and brain). Neural tube defects have a range of presentations, from stillbirth to incidental radiographic findings of spina bifida occulta. The term myelodysplasia has been used as a synonym for Spina bifida. Lesions most commonly occur in the lumbar and sacral regions but can be found anywhere along the entire length of the spine.[1] It is a treatable spinal cord malformation that occurs in varying degrees of severity.

Spina Bifida

During the first month after conception, the embryo develops a primitive tissue structure known as the neural tube. This structure gradually develops into bones, nerves, and tissue. These eventually form the nervous system, the spinal column, and the spine, a ridge of bone that protects and surrounds the nerves. In spina bifida, the neural tube and spinal column do not develop properly. The spine does not close fully, and the spinal column remains exposed along several vertebrae. A sac forms on the fetus’ back as the membranes and spinal cord push out. The sac may be covered with meninges, or membranes

Tethered Cord

Tethered spinal cord syndrome is a neurologic disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. These attachments cause an abnormal stretching of the spinal cord. This syndrome is closely associated with spina bifida. It is estimated that 20-50% of children with spina bifida defects that are repaired shortly after birth will require surgery at some point to untether the spinal cord.

Shunt

In medicine, a shunt is a hole or a small passage which moves, or allows movement of, fluid from one part of the body to another. The term may describe either congenital or acquired shunts; and acquired shunts (sometimes referred to as iatrogenic shunts) may be either biological or mechanical.

Hydrocephalus

The term hydrocephalus is derived from two words: “hydro” meaning water, and “cephalus” referring to the head. Hydrocephalus is a condition in which excess cerebrospinal fluid (CSF) builds up within the ventricles (fluid-containing cavities) of the brain and may increase pressure within the head. Although hydrocephalus is often described as “water on the brain,” the “water” is actually CSF, a clear fluid surrounding the brain and spinal cord. CSF has three crucial functions: 1) it acts as a “shock absorber” for the brain and spinal cord; 2) it acts as a vehicle for delivering nutrients to the brain and removing waste; and 3) it flows between the cranium and spine to regulate changes in pressure within the brain. Hydrocephalus can occur at any age, but is most common in infants and adults age 60 and older. According to the National Institute of Neurological Disorders and Stroke, hydrocephalus is believed to affect approximately one in every 500 children. The majority of these cases are often diagnosed before birth, at the time of delivery, or in early childhood. The term hydrocephalus is derived from two words: “hydro” meaning water, and “cephalus” referring to the head.