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Uploaded byRinky Meena
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Neural tube defect [ntd]

Neural tube defects are openings in the spinal cord or brain that occur early in development when the neural tube fails to close fully. Common types include spina bifida, anencephaly, and encephalocele. Neural tube defects develop before most women know they are pregnant and are caused by factors like genetics, obesity, diabetes, malnutrition, certain medications, and low folic acid levels. They are diagnosed through MRI or CT scans and treated by a multidisciplinary team to address physical, developmental, and learning issues. Taking folic acid supplements before and during early pregnancy can help prevent most neural tube defects.

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NEURAL TUBE DEFECT [NTD] BY- RINKU MEENA
DEFINITION  It is an opening in the spinal cord or brain that occurs very early in the human development.  The early spinal cord of the embryo begins as a flat region which rolles into neural tube 28 days after the baby is conceived.  When the neural tube does not closes completely a NTD develops.  NTDs develop before most of the women know that they are pregnant.
ETIOLOGY Hyperthermia Drugs Malnutrition Maternal obesity or DM Diet low in folic acids
TYPES OF NTD ;  NTD are classified into two types  1] OPEN NTD  2] CLOSED NTD
OPEN NTD  Open NTDs are the most common type.  Open NTD occur when the brain and spinal cord are exposed at the birth through a defect in the skull and vertebra.  Ex- Spinal bifida , Anencephaly , Encephalocele
CLOSED NTD  IT occurs when the spinal defect is covered by skin .  Ex- Spina bifida occulta is the condition where there is a typical benign boney changes in one or more vertebrae but not involving the nerves with in the spinal column .  Its incidence is not well defined .  However it could be seen in the form of dimpaling on the back with some hair growth.  Anencephaly and Spina bifida accounts for about 95 % of all NTD.
CEPHALOCELES  Brain motor herniates through a defect in the skull.  A cranial mengiocele contains only menings but cephalocele contain ventricles which herniates from that part.  They are the rarest that Anencephaly . Its incidence is 1- 3/10000 live births.  IN some part of Asia anterior cephalocele are more common & may protrude into the nose , ethmoid or orbit.
Spina bifida occulta  Defect of posterior arch of one or more lumbar or sacral vertebrae.  Often found on X-rays in the children admitted to the hospital .  On examination revels hairy patch, dimple , subcutaneous mass.  MRI of spinal cord to find out associated problems the limb.
INVESTIGATION OF NTD;  MRI is the study of choice for imaging the neural tissues & for identification contents of defect in the new born.  CT scan allows direct visualization of the bony defect & anatomy.  USG is used antenatally for screening.
MANAGEMENT  Affected children will be getting treatment from multidisciplinary team to address any associated physical , development , hearing & visual & learning difficulties that may occur along c NTD.  The new born with an open neural tube defect should be kept warm & the defect is covered sterile saline dressing.  The baby should be positioned in a prone position to prevent pressure on the defect .  Open neural tube defect should be closed properly
prevention  Peri-conceptional folic acid supplement can prevent most of the neural tube defect .  4-5mg of folic acid should be obtained through prescription of doctor.
COMPLICATION  Infection  Associated motor & sensory problems particularly lower limbs.  Associated learning disability, development delay & varing impairment.  Bowel & bladder dysfunction.
Neural tube defect [ntd]