Spinal Dysraphism
Neural tube defects
Most common CNS anomaly
2:1000
Prevention:
Folate in pregnancy
Most diagnosed on antenatal scan
Consider if
neuro deficit
Hairy patch
Pit > cm from anus
Haemangioma
Cloacal exstrophy
anorectal anomaly
sacral anomaly
Complications:
Limbs
Bladder
Bowel
Latex allergy/anaphylaxis from recurrent catheterisation
If neurodeficit or mass > MRI
otherwise screen with US if <3m then MRI if abnormal (may be able to see cord if bone absent)
If normal US, no f/u
US ?
Low cord (inferior to body of L2 after 3m CGA)
Tethered cord
Extension of pit
Diastematomyelia (split cord)
Meningocele
Lipoma
Most common CNS anomaly
2:1000
Prevention:
Folate in pregnancy
Most diagnosed on antenatal scan
Consider if
neuro deficit
Hairy patch
Pit > cm from anus
Haemangioma
Cloacal exstrophy
anorectal anomaly
sacral anomaly
Complications:
Limbs
Bladder
Bowel
Latex allergy/anaphylaxis from recurrent catheterisation
If neurodeficit or mass > MRI
otherwise screen with US if <3m then MRI if abnormal (may be able to see cord if bone absent)
If normal US, no f/u
US ?
Low cord (inferior to body of L2 after 3m CGA)
Tethered cord
Extension of pit
Diastematomyelia (split cord)
Meningocele
Lipoma