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CAR: Anomalies - CNS

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    Neural tube
      Spina bifida


Introduction Antenatal Postnatal West Midlands Data


Encephalocele is the herniation of meninges and brain tissue outside the cranium usually, but not always, in the midline. As with spina bifida, the outcomes for encephalocele cases vary depending on the size of the lesion and the presence of other structural anomalies. As with other neural tube defects there are reported associations with maternal insulin dependent diabetes, hyperthermia, obesity at conception, autosomal trisomies, and low serum folate concentrations.

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Programmes for the prenatal diagnosis of neural tube defects are well developed in the West Midlands. Two methods of screening are in use, often together. The first is maternal serum AFP screening performed at 16 to 20 weeks gestation, the second is ultrasound screening, which is widely performed at 16 to 22 weeks for this purpose. AFP serum screening is less effective for encephalocele, which is usually skin covered and therefore not amenable to this technique.

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Encephalocele is similar to spina bifida in the variety of outcomes. Associated structural anomalies are relatively common, particularly renal anomalies, and need to be considered before other interventions are planned. Lesions may contain cerebrospinal fluid only or a varying amount of brain or spinal tissue. The prognosis depends on the size of the lesion, and associated CNS dysfunction. Small lesions containing little or no brain substance will tend to have a good prognosis.

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To be added.

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© Perinatal Institute 2011