Search results for "Meningomyelocele"
showing 10 items of 14 documents
Retrospective review of L3 myelomeningocele in three age groups: should posterolateral iliopsoas transfer still be indicated to stabilize the hip?
2005
The data from 58 hips in 29 myelodysplastic children with L3 paralysis has been reviewed retrospectively. Posterolateral transfer of the iliopsoas (Sharrard technique) was performed on all hips to correct muscle imbalance between 1975 and 1992. The average length of follow-up was 21 years. Preoperatively, 58.6% of the hips were either subluxated or dislocated (these were surgically reduced at the same stage). Radiological assessment revealed that 91.4% of the hips were stable at preschool age and 84.5% in adolescence. Of the patients 86% were functional walkers at preschool age and 75.8% in adolescence. Downward transitions in seven patients were related to the presence of scoliosis, spasti…
Assessment of brainstem function in Chiari II malformation utilizing brainstem auditory evoked potentials (BAEP), blink reflex and masseter reflex
2000
Brainstem dysfunction was evaluated in 67 patients with myelomeningocele and Chiari II malformation using brainstem auditory evoked potentials (BAEP), blink reflex (BR) and masseter reflex (MR). Signs and symptoms related to Chiari II malformation were observed in 18 patients while 49 patients had normal brainstem findings. BAEP and BR showed a higher sensitivity of brainstem involvement than MR (BAEP=1.0, BR=0.83, MR=0.50). BR, and in particular, MR were of higher accuracy (BR=0.52, MR=0.72) than BAEP (0.39) in separating patients with brainstem signs and symptoms related to Chiari II malformation. We feel that this is due to anatomic and physiologic peculiarities of the brainstem structur…
Orthopedic and neurosurgical treatment of severe kyphosis in myelomeningocele
1999
Kyphosis in myelomeningocele is characterized by a complex pattern of problems during development and therapy. On the one hand, decompensation of upright posture leads to loss of sitting ability and social integration; on the other hand, accompanying malformations and trophic alterations threaten the physical integrity and performance. Neurologic function, cerebrospinal fluid (CSF) circulation, skeletal deformity and the urinary transport system need to be kept in mind and need to be treated with cooperation between the different specialties. Especially during serious surgical interventions such as spinal surgery, neither the nervous system nor the kidneys must be ignored. Sixteen patients …
Masseter reflex and blink reflex abnormalities in Chiari II malformation.
2001
Masseter reflex and blink reflex were evaluated in 64 patients with a myelomeningocele and Chiari II malformation. In 46 patients, no brainstem signs or symptoms were present. Brainstem dysfunction related to Chiari II malformation occurred in 18 patients. The masseter reflex was more frequently abnormal in the symptomatic than asymptomatic patients (P = 0.02). Although the blink reflex was similarly affected in the two groups of patients (P > 0.1), it was very sensitive, being abnormal in 83% of symptomatic and 65% of asymptomatic patients. Concomitant abnormality of masseter reflex and the late contralateral blink reflex component (R2c) was almost exclusively found in symptomatic patients…
Development of scoliosis in myelomeningocele. Differences in the history caused by idiopathic pattern.
1993
The natural history of scoliosis in the literature concerning the idiopathic and neuromuscular scoliosis in myelomeningocele patients (MMC) are compared to our own results in 12 patients with MMC and 89 patients operated because of an idiopathic scoliosis. According to known experiences the natural history of scoliosis in MMC is progression even after the end of growth. The chance of developing a scoliosis increases with the patients, age and the level of the lesion. The higher the level of paralysis the more common is a spinal deformity. In literature the progression rate of MMC scoliosis is 2.5-3.5 degrees per year, with the idiopathic pattern 0.5-0.65 degrees per year after end of growth…
Somatosensory evoked potentials in Arnold-Chiari malformation.
2002
Abstract Nearly all patients with repaired myelomeningoceles have an Arnold–Chiari (AC) malformation and about 20% of these patients develop clinical signs of brainstem dysfunction. The management of symptomatic AC malformation is still controversial and techniques are needed to provide an objective assessment of brainstem function. We recorded somatosensory evoked potentials (SEPs) in 52 patients aged between 8 months and 20 years (median 7.3 years) with AC malformation, to determine whether the SEPs discriminate patients with symptomatic AC malformation from those without symptoms. The subcortical far-field components P13, P14 and N18, which are generated within the brainstem, were record…
Cerebral and spinal MR-findings in patients with postrepair myelomeningocele
1990
In 114 patients with postrepair myelomeningocele MRI of the spine was performed. Tethered cord (89%) and associated malformations (syrinx, lipoma etc.) (33%) were the most important findings. Additional MRI scans of the head (44 patients) revealed numerous further anomalies. Arnold Chiari malformation was found in 76% of the patients (ACM I: 32%, ACM II: 44%). In the ACM II group compression of lower cranial nerves, brain stem, and cerebellum can lead to considerable neurologic symptoms. Therefore in patients with progressive neurologic dysfunction a complete investigation of the whole spine and brain is necessary. MRI proves to be the diagnostic procedure of choice in patients with dysraph…
Magnetic resonance imaging of postrepair-myelomeningocele — findings in 31 children and adolescents
1987
Magnetic resonance imaging has clearly demonstrated its efficacy in the diagnosis of pathological processes in the C.N.S. We examined 31 children who had undergone plastic closure of myelomeningocele a few days post partum. We could show that a high percentage of the patients (89%) presented the pathological anatomy of a tethered spinal cord; clinical symptoms of the tethered spinal cord syndrome, i.e. progressive neurological symptoms, however, are rarely observed. Possible revision of neurosurgical treatment of MMC is discussed.
Recognizable neonatal clinical features of aplasia cutis congenita
2020
Abstract Background Aplasia cutis congenita (ACC), classified in nine groups, is likely to be underreported, since milder isolated lesions in wellbeing newborns could often be undetected, and solitary lesions in the context of polymalformative syndromes could not always be reported. Regardless of form and cause, therapeutic options have in common the aim to restore the deficient mechanical and immunological cutaneous protection and to limit the risk of fluid leakage or rupture of the exposed organs. We aimed to review our institutional prevalence, comorbidities, treatment and outcome of newborns with ACC. Methods We conducted a retrospective study including all newborns affected by ACC and …
Long-Term Followup of Children with Colon Conduit Urinary Diversion and Ureterosigmoidostomy
1977
Sixty-four children underwent colon conduit urinary diversion because of a neurogenic bladder owing to myelomeningocele and 39 children required a ureterosigmoidostomy because of bladder exstrophy. The average length of followup was 4.6 years after colon conduit and 5.6 years after ureterosigmoidostomy. Colon conduit diversion was secondary in 3 children and ureterosigmoidostomy was secondary in 5. Of the children with a colon conduit 9.4% and of those with ureterosigmoidostomy 12.8% had postoperative surgical complications. Late surgical complications were encountered after colon conduit in 14.5% and after ureterosigmoidostomy in 20%. Of the children with normal renal function preoperative…