ISSN: 1305-3876
Dil: Türkçe
Hakkında: Özel sayılar şeklinde yayınlanır.
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Neurosurgical Emergencies In Spinal Dysraphism
Dr. Saim KAZAN,a Dr. V.Umut TURGUTa
aNöroşirürji AD, Akdeniz Üniversitesi Tıp Fakültesi, ANTALYA
The expressions of spina bifida range from the minimum of an absent spinous process to multiple vertebral anomalies with marked changes in spinal cord anatomy and function. In the clinical context, spinal dysraphism is an umbrella term used to designate all the pathologic forms, open and closed, of spina bifida.
Meningocele is the simplest form of open spinal dyraphism. In case of disruption of meningocele cyst, prompt neurosurgical intervention should be applied after having the optimal circumstances. The far more common form of open neural tube defect is myelomeningocele. The neurologic deficits associated with myelomeningocele are usually permanent and irreversible. The goals of early operative care for a neonate with an myelomeningocele are 1) preserving all viable neural tissue, 2) reconstituting the normal anatomic environment, and 3) minimizing the chance of infection or preventing ascending infection of the neural axis.
The tethered spinal kord syndrome consists of a group of dysraphic conditions such as tight and thick filum, lipomateous filum terminale, dermal sinus tract, lipomyelomeningocele, split cord malformation, myelocystocele and operated myelomeningocele. In these conditions, the conus medullaris is located in an anormally low position and is fixed there in relatively immobile state. Irreversible neuronal damage can occur when sudden stretching of the already chronically tethered cord occurs. Early untethering, when minimum or mild symptoms are detected, is essential for tethered cord syndrome treatment.Keywords: Neurosurgery, spinal dysrafismTurkiye Klinikleri J Surg Med Sci 2007, 3(11):77-82
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