Arnold Chiari Malformation with Spina Bifida: A Lost Opportunity of Folic Acid Supplementation

December 2014
Journal of Clinical & Diagnostic Research;Dec2014, Vol. 8 Issue 12, p1
Academic Journal
Case Study
In Arnold Chiari (kee-AHR-ee) II malformation elongated cerebellar tonsils are displaced inferiorly through the Foramen Magnum into the upper cervical spinal canal. It is a complex anomaly with skull, dura, brain, spine and cord manifestations. Meningomyelocele is seen in all cases. We present a case of type II Arnold Chiari Malformation diagnosed in utero in a pregnant lady .There was no periconceptional folic acid supplementation. As the role of the Methylene Tetra Hydro Folate Reductase gene polymorphism in neural tube defects is becoming evident, a simple opportunity as folic acid supplementation should not be missed. Folate supplementation as fortification of cereal grains will also prevent other conditions like congenital heart defects, urinary tract anomalies, orofacial defects, limb defects and pyloric stenosis.


Related Articles

  • Meningomiyelosel ve Arnold-Chiari malformasyonu: 45 vakanın deÄŸerlendirilmesi. Çelik, H. Tolga; Meliboyev, Mavlon; Nizamov, İhtiyar; Yurdakök, Murat // Cocuk Sagligi ve Hastaliklari Dergisi;oca-mar2010, Vol. 53 Issue 1, p10 

    The aim of this study was to evaluate retrospectively the patients born in our hospital with neural tube defects. We investigated the demographic, prenatal, natal and postnatal features, familial risk factors, physical and radiological findings, and accompanying diseases of 45 (19 females, 26...

  • Language Differences in Young Children with Myelomeningocele and Shunted Hydrocephalus. Vachha, Behroze; Adams, Richard // Pediatric Neurosurgery;Oct2003, Vol. 39 Issue 4, p184 

    Objective: This comparative cohort study examined language differences in young children (preschool to first grade) with myelomeningocele and shunted hydrocephalus (MM/SH). Method: A well-validated, standardized language test was administered to 17 children with MM/SH (age range 4–6...

  • Primary and secondary management of the Chiari II malformation in children with myelomeningocele. Messing-Jünger, Martina; Röhrig, Andreas // Child's Nervous System;Sep2013, Vol. 29 Issue 9, p1553 

    Object: Chiari malformation type II is almost exclusively found in patients with open spinal dysraphism. Etiology and pathophysiology are not yet completely understood, and management guidelines regarding the best follow-up and treatment of this pathological entity do not exist. In order to...

  • Pathogenesis of cerebral malformations in human fetuses with meningomyelocele. de Wit, Olga A.; den Dunnen, Wilfred F. A.; Sollie, Krystyne M.; Muñoz, Rosa Iris; Meiners, Linda C.; Brouwer, Oebele F.; Rodríguez, Esteban M.; Sival, Deborah A. // Cerebrospinal Fluid Research;2008, Vol. 5, Special section p1 

    Background: Fetal spina bifida aperta (SBA) is characterized by a spinal meningomyelocele (MMC) and associated with cerebral pathology, such as hydrocephalus and Chiari II malformation. In various animal models, it has been suggested that a loss of ventricular lining (neuroepithelial/ependymal...

  • Complex forms of spinal dysraphism. Patnaik, Ashis; Mahapatra, Ashok // Child's Nervous System;Sep2013, Vol. 29 Issue 9, p1527 

    Introduction: Spinal dysraphisms are a heterogeneous group of congenital malformations involving the bony component of vertebrae or spinal cord or both. Simple forms include the contiguous, solitary malformations such as myelomeningocele and diastematomyelia, and can be either aperta or occulta...

  • Cerebellar Motor Function in Spina Bifida Meningomyelocele. Dennis, Maureen; Salman, Michael; Juranek, Jenifer; Fletcher, Jack // Cerebellum;Dec2010, Vol. 9 Issue 4, p484 

    Spina bifida meningomyelocele (SBM), a congenital neurodevelopmental disorder, involves dysmorphology of the cerebellum, and its most obvious manifestations are motor deficits. This paper reviews cerebellar neuropathology and motor function across several motor systems well studied in SBM in...

  • Post-operative complications associated in patients with spina bifida: an analysis of shunted patients. Delgado, Eliana D.; Franco, Gina C.; Pearson, Caroline // Cerebrospinal Fluid Research;2005 Supplement 1, Vol. 2, pS45 

    Background All Spina Bifida patients with Myelomeningocele require specialty care from Orthopaedics, Neurology, Urology, GI and Plastics. A high percentage of these patients require surgery as a treatment modality. This outcome research study illustrated increased compilations post surgery in...

  • Imaging the course of a hypoplastic cerebellum in a spina bifida newborn. Kronenburg, Annick; Han, Kuo; Gooskens, Rob; Esposito, Giuseppe; Cochrane, Douglas; Woerdeman, Peter // Child's Nervous System;Nov2013, Vol. 29 Issue 11, p2131 

    Introduction: We report about a spina bifida patient with myelomeningocele at the lumbar level L5, extensive Chiari malformation type II with vermal herniation reaching to C6 with downward pontine shift, and a severe hypoplastic cerebellum. Chromosomal diagnostic tests showed no abnormalities....

  • Effect of Intrauterine Myelomeningocele Repair on Central Nervous System Structure and Function. Tulipan, Noel; Bruner, Joseph P.; Hernanz-Schulman, Marta; Lowe, Lisa H.; Walsh, William F.; Nickolaus, Delia; Oakes, W. Jerry // Pediatric Neurosurgery;Oct99, Vol. 31 Issue 4, p183 

    Background: It has been postulated that intrauterine myelomeningocele repair might improve neurologic outcome in patients with myelomeningocele. A total of 59 such procedures have been performed at Vanderbilt University. Preliminary results suggested that the degree of hindbrain herniation is...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics