Refresh your
knowledge on Anencephaly :Need not read
any books: look at my head: My grandson
& granddaughters particularly have eaten half of my head by not getting chocolates
-As such I have become anencephalic!!!
Defn:-Anemophily is characterized by the absence
of the cranial
vault and
telencephalon. Necrotic remnants of the brain stem and
rhomboencephalic structures are covered
by a vascular membrane.
What
may be associated malformations outside the head?? Ans:- Associated malformations are common
and include spina bifida cleft lip /
palate clubfoot and omphalocele
When
to clinically suspect in pre USG era? (Prior
to 1980)?? . We
used to think of this D/D in 1967-1981 (when first USG machine was installed at
Eden Hospital, Medical College Kolkata)
as anencephaly is frequently associated with Polyhydramnios. Now after widespread
availability of USG centers at every lane and bye lane : The
diagnosis is easy in the second and
third trimester and relies on the
demonstrations of the absence of the
cranial vault
Pathogensis ?? .Anencephaly is considered to be the
final stage of acrania as a consequence of disruption of abnormal brain tissue
unprotected by the calvarium .
Although the term acrania
is often used in conjunction with anencephaly the term implies
absence of the
entire skull including the
skull base which is not true in
anencephaly. The skull base is present
in anencephaly and the calvarium is absent
How early anencephaly can
be picked up??
Ans:-The fetal head can be positively identified by vaginal sonography as
early as the 7th week of
gestation the diagnosis may be difficult in the first trimester . But one
caveat. The absent calvarial mineralizataion before 10 to 12
weeks gestation makes the
differentiation of normal and
abnormal brain difficult. Therefore a cephalic pole albeit overtly abnormal is usually
present in early gestation and may be difficult to identify and differentiate from the normal brain before
11 weeks gestation .
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