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Spina Bifida and Hydrocephalus awareness

Spina Bifida and Hydrocephalus awareness



Overview

Spina bifida awareness is promoted on World Spina Bifida and Hydrocephalus Day, observed annually on October 25th to raise understanding of these birth defects and advocate for affected individuals' rights. Spina bifida is a defect where the spine and spinal cord don't close properly during pregnancy, while hydrocephalus is a buildup of fluid in the brain that can occur as a complication of spina bifida. Awareness campaigns aim to reduce stigma and promote inclusion for people with these conditions, highlighting that timely care can lead to fulfilling lives.  

What are Spina Bifida and Hydrocephalus?

Spina Bifida: A neural tube defect where the spine doesn't close completely during early pregnancy, potentially exposing the spinal cord to damage. It ranges in severity, from mild forms with no outward symptoms to severe forms where spinal elements protrude. 

Hydrocephalus: A condition characterized by an excess buildup of cerebrospinal fluid (CSF) in the brain, which increases pressure within the skull. It is a common complication of severe spina bifida, occurring in a high percentage of affected babies. 

Spina Bifida Symptoms

On the Back: A dimple, hair patch, birthmark, or a noticeable bulge (sac) on the lower back. 

Movement & Sensation: Weakness or paralysis in the legs, difficulty walking, and a lack of normal feeling in the lower body. 

Bowel & Bladder: Loss of control over bladder and bowel function (incontinence). 

Cognitive: Learning disabilities and difficulty swallowing. 

Other Issues: Bone problems, heart problems, and increased risk of latex allergy. 

Hydrocephalus Symptoms (often linked to Spina Bifida)

In Infants: A bulging "soft spot" (fontanelle) on the skull, an increasing head size, and veins that appear larger on the scalp. 

In Older Children: Headaches, vision problems (blurred or double vision), nausea and vomiting, and excessive tiredness. 

General Symptoms: Poor appetite, slowed development, difficulty with balance, and changes in personality or increased irritability. 

Spina Bifida Causes & Risk Factors

Folic Acid Deficiency: Not getting enough folic acid before and early in pregnancy is a significant risk factor. 

Genetics: Having a family history of spina bifida or another neural tube defect increases the risk. 

Maternal Medications: Certain medications, such as some anti-seizure drugs like valproate, increase the risk of a baby developing spina bifida. 

Pre-existing Conditions: Women with uncontrolled diabetes or obesity are at a higher risk of having a baby with spina bifida. 

Environmental Factors: Early exposure to certain substances like some solvents, lead, and herbicides may also play a role. 

Hydrocephalus Causes & Risk Factors

Hydrocephalus occurs when cerebrospinal fluid (CSF) accumulates, causing pressure on the brain. While it often occurs in conjunction with spina bifida, other causes include: 

Spina Bifida: 80-90% of children with spina bifida will develop hydrocephalus. 

Infections: Viral or bacterial infections, such as meningitis, can lead to hydrocephalus. 

Brain Tumors: Tumors or cysts in the brain can block the flow of CSF. 

Brain Injury: Trauma to the head can cause hydrocephalus. 

Premature Birth: Being born prematurely can also increase the risk. 

Diagnosis

Diagnosis of Spina Bifida

During Pregnancy (Prenatal)

Alpha-fetoprotein (AFP) Blood Test: A high level of AFP can indicate an increased risk of spina bifida. 

Ultrasound: A second-trimester ultrasound (around 18-22 weeks) is a reliable way to detect spina bifida by showing an open spine or features in the baby's brain. 

Amniocentesis: If spina bifida is suspected, this test can be performed to check for genetic conditions. 

Fetal MRI: This can be used to show the severity of the condition. 

After Birth (Postnatal)

Physical Examination: A doctor may observe a dimple, patch of hair, or sac on the baby's back at birth. 

Imaging Tests:

Ultrasound: Used to get a clearer view of the spinal cord and vertebrae. 

X-ray: Helps to see the extent of the spinal defect. 

MRI or CT Scan: Provides detailed images of the spinal cord and brain to confirm the diagnosis and assess associated conditions like hydrocephalus. 

Spina Bifida Occulta: This milder form may be found incidentally on an X-ray or other imaging study done for another reason. 

Diagnosis of Hydrocephalus

In Infants

Head Circumference Measurement: A rapidly increasing head size is a key indicator. 

Brain Imaging: Ultrasound, CT scan, or MRI are used to detect the enlarged ventricles (fluid-filled spaces) in the brain. 

In Older Children and Adults

Neurological Evaluation: May be performed, looking for symptoms like difficulty concentrating, memory issues, and changes in personality. 

Brain Imaging (CT or MRI): Essential for visualizing the increased fluid and enlarged ventricles, confirming the diagnosis. 

Awareness

Raising awareness about spina bifida and hydrocephalus is crucial for early detection and intervention. This includes educating the public about prenatal screening options, the importance of folic acid intake to reduce risk, and recognizing potential symptoms after birth to ensure timely medical care, which can significantly improve outcomes and quality of life. 

Treatment

Surgical Treatment

Postnatal Surgery: A baby with spina bifida may have surgery to close the opening in their spine and prevent infection and further damage to the nerves. 

Fetal Surgery: In some cases, surgery can be performed while the baby is still in the womb (fetal surgery) to close the spinal defect and potentially reduce disability and the need for a shunt. 

Shunt Placement: If a baby develops hydrocephalus (excess fluid in the brain) along with spina bifida, a shunt may be surgically placed to drain the fluid, often into the abdomen. 

Ongoing Care and Therapies

Multidisciplinary Team: A team of specialists is often involved, including neurosurgeons, urologists, orthopedic surgeons, physical therapists, occupational therapists, and social workers, to manage the various complications of spina bifida. 

Physical and Occupational Therapy: These therapies help children develop skills and improve independence with mobility, using assistive devices such as wheelchairs or walking aids. 

Bowel and Bladder Management: Treatments are available to manage bladder and bowel problems, such as clean intermittent catheterization (CIC), suppositories, or surgical options like antegrade continence enema (ACE). 

Support: Emotional and educational support is also available to help individuals with spina bifida and their families. 

Type of Doctor Department : Neurosurgeons and neurologists

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