Presentation
Adult presentation of myelomeningocele is exceedingly rare. Case presentation: We present a 74 years Caucasian female was transferred to our institution for evaluation of purulent drainage around an unrepaired myelomeningocele site. [omicsonline.org]
Presentation Chiari type I [ 5 ] The presentation of this condition depends upon the severity of the herniation and associated other features. [patient.info]
Age and Sex edits from the Medicare Code Editor alert you to codes that are used only with patients of a specific age or sex, helping to ensure accurate reporting Present on Admission symbol highlights the diseases that will always be coded as present [books.google.com]
On Admission POA Help "Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are [icd10data.com]
Symptoms of brain stem dysfunction, related to an Arnold Chiari malformation, also often present in infancy. Neurogenic bladder is common and often presents at birth. Early childhood Developmental delays are common. [now.aapmr.org]
Entire Body System
- Disability
EDF, the representative organisation of 65 million persons with disabilities in Europe, gathered more than 200 participants from 30 national federations and 50 European disability NGOs to elect its leaders. [ifglobal.sitehosting.be]
Children with spina bifida often have a number of learning disabilities and sometimes cognitive disabilities. These disabilities may include trouble paying attention, expressing or understanding language, and grasping reading and math. [birthinjuryguide.org]
Children with physical disabilities are often described by their disabilities, and not by their strengths or abilities, which are also important. [hawaii.edu]
We investigated the health, disability, lifestyle and cognitive function in adults who had myelomeningocoele closure at birth. Adult patients under routine follow-up were assessed in a joint neurosurgery/neuropsychology clinic. [pdfs.semanticscholar.org]
Please enable JS and disable any ad blocker [cairn.info]
- Hyperthermia
Maternal risk factors Folic acid deficiency [about 50% of cases are attributed] Pregestational diabetes – increases the risk of CNS malformation Maternal obesity Hyperthermia Maternal diarrhea Intrauterine exposure to antiepileptic drugs and drugs used [boneandspine.com]
Exposure to hyperthermia and certain medications, such as valproic acid and carbamezapine, also increase the risk. [now.aapmr.org]
[…] socioeconomic status Theories Recessive inheritance with less than 1:4 ratio due to early fetal loss (Lorber) Environmental factors (Von Reckllinghausen) Hamartomatous growth (Pattern) Association with: Low maternal dietary folate Maternal IDDM Maternal hyperthermia [orthopaedicsone.com]
Urogenital
- Urinary Incontinence
Classically, the young child who has become toilet trained begins to experience urinary incontinence and urgency. [cns.org]
Difficulties with bowel and bladder function may become evident with urinary and fecal urgency and/or incontinence, urinary tract infections, dribbling urinary stream, incomplete emptying, or inability to void. [pediatrics.aappublications.org]
- Cesarean Section
Delivery of an infant with a suspected open myelomeningocele should be by Cesarean section, in order to avoid the risk of infection during passage along the birth canal; the child should be nursed on its front or side, with a sterile moist dressing covering [thamburaj.com]
Workup
Isolated coccygeal dimples do not require further workup or treatment. FIGURE 9 Benign coccygeal dimple within the gluteal cleft and overlying the tip of the coccyx. [pediatrics.aappublications.org]
Treatment
Astoundingly she never proceeded to get a life threatening infection and, besides her urostomy, she had no other surgical treatments. The treatment of myelomeningocele has evolved dramatically over the last half century. [omicsonline.org]
Treatments for Hydrocephalus If hydrocephalus is not creating symptoms, or if it is due to temporary obstruction, treatment may consist of monitoring the condition instead of intervening. In most cases, though, hydrocephalus is treated with surgery. [princetonbrainandspine.com]
Treatment of Hydrocephalus The most common treatment of hydrocephalus involves diverting the buildup of CSF to somewhere else in the body through the use of a device called a shunt. [neurosurgery.ufl.edu]
The tremendous ethical implications of selected neonatal treatment led to its abandonment. [spinabifidasupport.com]
Prognosis
The prognosis otherwise depends on severity of the malformation, associated neurological abnormalities and complications. There has been some improvement in prognosis with improved diagnostic and surgical techniques. [patient.info]
Treatment and prognosis The overall prognosis is variable depending on the type and extent. For an isolated spina bifida, the recurrence risk range for future pregnancies is thought to be around 0.3-5% 12-13. [radiopaedia.org]
One needs to be cautious about providing too optimistic a prognosis with respect to neurologic dysfunction based on a neonatal examination and to recognize that the appearance of neurologic deficits may not indicate deterioration. [ncbi.nlm.nih.gov]
Prognosis varies by the level of cord involvement and the number and severity of associated anomalies. [merckmanuals.com]
Spastic paraparesis has been associated with a poorer prognosis for walking and higher rates of orthopedic procedures. [emedicine.medscape.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
[…] body system manifestations due to the underlying etiology. [icd10data.com]
Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]
The etiology is often multifactorial with both genetic and environmental factors considered to play a role. Intake of adequate amounts of folic acid plays a protective role. Classification There are many ways of classifying a spina bifida. [radiopaedia.org]
Etiology MM is a result of failure of the normal development of the neural tube, which typically starts on day 16 and is complete by day 28. [now.aapmr.org]
Epidemiology
Epidemiology including risk factors and primary prevention The birth prevalence of MM is 2:10,000 live births. 1 Most cases of MM occur sporadically and are felt to have a multifactorial etiology. [now.aapmr.org]
Epidemiology Chiari type I Retrospective investigation of brain MRIs has found a prevalence of 1 in 1,280 individuals [ 5 ]. It tends to present earlier if there is syringomyelia. [patient.info]
Pathophysiology
Normal Physiology and Pathophysiology of Hydrocephalus Cerebrospinal fluid (CSF) is a liquid that normally surrounds the brain and spinal cord, serving to cushion the nervous tissue as well as wash away metabolic byproducts. [cns.org]
Normal Embryology and the Pathophysiology of Spinal Cord Tethering Dysraphic CNS malformations arise during the second, third, and fourth weeks of human embryogenesis, generally referred to as the period of neurulation. [pediatrics.aappublications.org]
Prevention
0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis [medicbind.com]
Prevention is the best approach. [hawaii.edu]
These malformations can be prevented with the technique of MMC closure [ 10, 11 ]. [jneuro.com]
If the myelomeningocele is leaking CSF, antibiotics are started to prevent meningitis. [merckmanuals.com]
Prevention of isolated spina bifida and other spinal abnormalities has become possible during recent decades. The major prevention is through the use of a B vitamin, folic acid, for several months prior to and following conception. [medical-dictionary.thefreedictionary.com]