Postnatal management and outcome for neural tube defects including spina bifida and encephalocoeles.
The incidence of neural tube defects (NTDs) has declined in recent decades, however myelomeningocele and encephalocele still represent one of the commoner prenatally diagnosed congenital malformations. Improved perinatal and post natal care mean that the mortality associated with these conditions has also fallen. Advances in the multidisciplinary management of children with myelomeningocele have led to significant improvements in functional outcome for many with this condition. However, there remains a substantial population of patients born with NTDs whose life expectancy is substantially reduced and who suffer significant cognitive and physical disability remaining wholly or partially dependant on the care of others into adult life. This article aims to outline the contemporary early management of these conditions and examine the prospects for functional outcome where possible, attempting to show how early anatomical features of these conditions can help predict where, along the wide spectrum of outcome, a given individual may lie.
Thompson
Dominic N P
DN
Department of Neurosurgery, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK. thompd@gosh.nhs.uk
D001921:Brain / Q000002:abnormalities; D003071:Cognition; D036861:Delivery, Obstetric / Q000379:methods; D004677:Encephalocele / Q000150:complications / Q000628:therapy*; D005260:Female; D005315:Fetal Diseases / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000601:surgery; D007231:Infant, Newborn; D008591:Meningomyelocele / Q000150:complications / Q000628:therapy; D009436:Neural Tube Defects / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D026741:Physical Therapy Modalities; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011300:Preoperative Care; D011379:Prognosis; D016135:Spinal Dysraphism / Q000150:complications / Q000628:therapy*; D015996:Survival Rate; D016138:Walking