Occult Spinal Dysraphism PDF Download

Author: R. Shane Tubbs
Publisher: Springer
ISBN: 3030109941
Category : Medical
Languages : en
Pages : 357

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Book Description
This volume covers the known details of all subtypes of occult spinal dysraphism in unprecedented detail. This 21 chapter invaluable resource begins with a deep dive into the history and embryology of occult spinal dysraphisms. Following this, subtypes of occult spinal dysraphism are thoroughly explored — of which include split cord malformations, tethered cord syndromes, adult presentations/outcomes of occult spinal dysraphism, cutaneous stigmata. Chapters will cover the clinical presentation, radiological features, and surgical nuances of each of the occult spinal dysraphisms. Throughout the book, expertly written text is supplemented by a number of high quality figures and tables, as well as a video documenting surgical treatment of type 1 split cord malformation. By focusing on each entity currently grouped within this topic as a separate chapter, the most up-to-date information will be provided to the reader, making Occult Spinal Dysraphism a must-have resource for students, practitioners and medical professionals involved in treating spinal dsyraphism.

Author: M. Memet Özek
Publisher: Springer Science & Business Media
ISBN: 8847006511
Category : Medical
Languages : en
Pages : 523

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Book Description
The aim of this book to promote a multidisciplinary approach to Spina Bifida, providing the three main specialists categories involved – neurosurgeon, orthopedic surgeons, and urologists – with a concise reference that explains the main clinical problems to be faced in everyday clinical practice. The book also provides the busy specialist with an updated overview of surgical approaches.

Author: Peter Wide
Publisher: Linköping University Electronic Press
ISBN: 9179297889
Category : Electronic books
Languages : sv
Pages : 71

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Book Description
Spinal dysraphism (SD) is a congenital malformation that to a varying extent, often severely, affects the life of the child and the family. Most individuals with SD suffer from neurogenic bladder and bowel dysfunction—with the risk of urinary tract infections, renal deterioration, urinary and fecal incontinence—that affects social participation and quality of life negatively. In newborns with SD, early detection of neurogenic bladder dysfunction and determination of post-void residual urine are required to determine the need of clean intermittent catheterization (CIC) and follow-up. The non-invasive method of four-hour voiding observation with provocation test (VOP) was used to evaluate bladder function in 50 newborn children with SD. Voiding patterns for the children were described and compared with those of 50 healthy newborns evaluated with VOP in an earlier study. Comparison revealed significant differences among several variables. In particular, leakage at provocation test and not voiding with a stream were common in newborns with SD but did not occur in healthy newborns. VOP is a non-invasive standardized method to determine residual urine in newborns with SD. It also adds information on voiding pattern, frequency, voiding with a stream and leakage at provocation. Findings in neonatal VOP of the same cohort of newborns with SD were then related to radiology, presence of urinary tract infections during the first year, and urodynamic findings and use of CIC at the age of one year. It was found that, in children with SD, not voiding with a stream may have a predictive value for the need of CIC at the age of one year, followed probably by lifelong CIC. Despite this, the presence of an open SD per se has stronger predictive value, and each child needs to be evaluated individually while considering a number of factors. The main value of VOP may be as a structured non-invasive screening method to uncover neurogenic bladder-sphincter dysfunction in the newborn. Studies with a larger number of subjects than the present are needed to evaluate the potential of VOP in newborns with closed spinal dysraphism in whom the neurological consequences vary. A retrospective analysis detected renal damage on DMSA scintigraphy in 5 of 41 children with SD who were followed according to a proactive national program with minimal use of surgery. Median follow-up time was 10 years. High baseline pressure was confirmed as a risk factor for renal damage. Compliance with treatment and follow-up is likely to be an important factor for renal health. Therefore, efforts to support children and their families are crucial. A questionnaire-based study of 107 children with SD (age 6–16y) in Sweden and Norway examined aspects of treatment for neurogenic bowel dysfunction focusing on incontinence, independence, general satisfaction and quality of life. It was found that transanal irrigation (TAI) and antegrade colonic enemas (ACE) are effective treatments, but are time-consuming and difficult to perform independently. The majority of children using TAI (72%) and ACE (63%) never went to the toilet alone to empty their bowels. As children achieving independence on the toilet reported higher quality of life, efforts to support independence are beneficial. Continent, self-managing children with healthy kidneys enjoy high quality of life and contribute more fully to society. Therefore, further research is required to investigate and develop existing and new technologies and methods that mitigate the problems related to SD, and to make them accessible to all children with spinal dysraphism. Under de senaste 50 åren har det skett en enastående utveckling av möjligheterna för barn som föds med ryggmärgsbråck. Tidigare har majoriteten av barn med ryggmärgsbråck avlidit redan som spädbarn men idag överlever de flesta till vuxen ålder. Utan aktiva insatser och uppföljning är dock risken för medicinska problem och allvarlig påverkan på livet mycket stor. Nu när nästan alla barn överlever ligger fokus på att också nå okad livskvalitet och självständighet för personer med ryggmärgsbråck. Nästan alla med ryggmärgsbråck måste hantera en allvarlig påverkan på blåsan och tarmen med risk för njurskador, inkontinens och förstoppning. I avhandlingens två första studier värderade vi en metod att, med minimalt obehag för barnet, bedöma blåsfunktionen. Detta för att kunna skilja ut de barn som behöver genomgå mer avancerade undersökningar och få hjälp med blåstömningen genom täta tappningar med kateter, sa kallad ren intermittent kateterisering, RIK. När vi jämförde resultatet av testet för 50 nyfödda med ryggmärgsbråck med samma undersökning av 50 friska nyfödda fann vi stora skillnader. Mest tydligt var att de flesta nyfödda med ryggmärgsbråck (69%) men inga friska nyfödda läckte urin när man tryckte över blåsan. Av nyfödda med ryggmärgsbråck kissade de flesta (74%) inte med stråle vilket alla friska nyfödda gjorde. Att inte kissa med stråle talade också starkt för att barnet skulle komma att behöva hjälp med RIK för att tomma blåsan vid ett ars ålder, och då sannolikt livet ut. Sammantaget visade avhandlingens två första arbeten att den metod för bedömning av blåsfunktion vi undersökt kan användas för att styra uppföljning och behandling av nyfödda med ryggmärgsbråck. Avhandlingens tredje studie visade att aktiv uppföljning av barnen enligt ett nationellt vårdprogram lyckades förhindra njurskador hos de flesta, men att höga tryck i urinblåsan och återkommande urinvägsinfektioner ökade risken för skador. Även familjernas förmåga att i en pressad vardag klara av att genomföra de ofta krävande behandlingar och undersökningar som rekommenderas verkade vara viktig för att förhindra njurskador. Stöttning av familjerna är därför viktig. Avhandlingens fjärde arbete berörde tarmen som nästan alltid är påverkad vid ryggmärgsbråck, med risk för svår förstoppning och avföringsläckage. Detta har påtaglig påverkan på barnen och deras familjer. En tredjedel av de 107 familjerna i vår enkätundersökning i Sverige och Norge (barn 6-16 år) beskrev att man fått avstå från aktiviteter såsom resor på grund av barnets tarmproblem och de barn som hade avföringsläckage rapporterade tydligt lägre livskvalitet än andra. Trots denna allvarliga påverkan finns det hittills inga studier som jämför de olika behandlingar som barnet kan använda. I vår enkät kartlade vi därför vilka metoder som användes och hur bra de fungerade. Vi ställde frågor till både barn och föräldrar, särskilt om avföringsläckage, hur nöjd man var med metoden, barnens livskvalitet och självständighet på toaletten. Det var utifrån svaren tydligt att båda de vanligaste typerna av tarmsköljning var effektiva men tidskrävande och svara för barn och ungdomar att klara att utföra på egen hand. Ingen metod visade sig överlägsen den andra men de barn som klarade att skota tarmtomningen själva skattade sin livskvalitet klart högre än övriga. Vi drar därför slutsatsen att det är viktigt att vårdpersonal diskuterar de olika behandlingsalternativen med barn och föräldrar, och tillsammans med dem väljer den metod som passar det enskilda barnet bäst. Då skapas bästa förutsättningar för att gemensamt arbeta vidare för att uppnå största möjliga självständighet. Självständiga individer, med friska njurar och utan urin- och avföringsinkontinens upplever högre livskvalitet och behöver mindre sjukvård och andra samhällsinsatser. Det behövs mer forskning för att utveckla existerande och nya metoder att hantera de allvarliga komplikationer som riskerar att drabba barn och vuxna med ryggmärgsbråck.

Author: Branislav Kolarovszki
Publisher: BoD – Books on Demand
ISBN: 1839629509
Category : Medical
Languages : en
Pages : 174

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Book Description
This book is a comprehensive overview of spina bifida and craniosynostosis with emphasis on new trends in the management of these diseases. Chapters on spina bifida cover such topics as the etiology and pathophysiology of caudal neural tube defects, the overall management of pediatric patients with spina bifida, surgical treatment, and urological and orthopedic care. The chapters on craniosynostosis present new technologies of surgical treatment, craniomaxillofacial corrective surgery, and telescoping techniques with multiple cranial osteotomies.

Author: Behrooz A. Akbarnia
Publisher: Springer Science & Business Media
ISBN: 3540852077
Category : Medical
Languages : en
Pages : 624

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Book Description
Spinal disorders in very young children may be caused by a variety of conditions. The treatment of such conditions is often challenging due to the age of the patient and the progressive nature of the deformity. There also may be associated problems such as congenital anomalies, respiratory insufficiency, and neurological problems. Depending on the etiology of the deformity, these children are often cared for by multiple specialists including pediatricians, pediatric orthopaedists or orthopaedic spine surgeons, neurologists, pediatric surgeons, pediatric neurosurgeons, oncologists, and/or pulmonologists. Health professionals in all of the mentioned disciplines are involved in the management of these patients, which is why compiling a comprehensive textbook that is not limited to orthopedic specialists is essential. This textbook will effectively help to standardize the care of these patients. Furthermore, other professionals such as nurses, physical therapists and healthcare professionals in training are usually not familiar with these conditions and are in need of a reference book to consult when caring for children with spinal deformities.

Author: Concezio Di Rocco
Publisher: Springer
ISBN: 9783319721675
Category : Medical
Languages : en
Pages : 0

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Book Description
This book documents the state of the art in pediatric neurosurgery with the intention of providing a comprehensive guide to the management of the full range of pediatric neurosurgical disorders that will aid in the delivery of optimal care. Detailed practical instruction, taking into account recent advances, is provided on the neurosurgical treatment of congenital brain malformations, cerebrovascular diseases, head injuries and spinal trauma, infections, functional disorders, congenital and developmental spinal disorders, and brain and spinal tumors. Pearls and pitfalls are highlighted, and attention drawn to the most useful tips and tricks. Information is also included on relevant related topics, including the principles of neuroimaging, the physiological responses of newborns, infants, and children to neurosurgical trauma, preoperative evaluation, anesthesiology and intensive care, and other forms of therapy. The authors are renowned experts in the field, and the text is supported by a wealth of high-quality images. Handbook of Pediatric Neurosurgery will be of value for neurosurgeons of all levels of experience, as well as for pediatricians, neuroradiologists, neuropathologists, and neuro-oncologists.

Author: L. Santiago Medina
Publisher: Springer
ISBN: 9781461433194
Category : Medical
Languages : en
Pages : 0

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Book Description
Evidence-Based Neuroimaging is a user-friendly guide that employs evidence-based medicine criteria to systematically review the evidence defining the appropriate use of medical imaging for the brain, spine, head, and neck. Edited by L. Santiago Medina, Pina C. Sanelli, and Jeffrey G. Jarvik, the book provides a systematic framework for understanding the best imaging choices for patient care. Chapters highlight key points that support clinical applications, allowing fast access to pertinent information including patient selection, imaging strategies, test performance, cost-effectiveness, and applicability. The diagnostic imaging of many common diseases, disorders, and conditions are covered, including multiple sclerosis, acute ischemic stroke, dementia, Alzheimer’s disease, traumatic brain injury, autism, spinal trauma, spinal infections, neck masses, thyroid cancer, and cervical lymph node metastasis. By offering a clear understanding of the science behind the evidence, the book fills a void for radiologists, neurologists, neurosurgeons, pediatricians, primary care physicians, and other clinicians with an interest in neuroimaging and a desire to implement an evidence-based approach into their daily practice.

Author: N. Tamaki
Publisher: Springer Science & Business Media
ISBN: 443167893X
Category : Medical
Languages : en
Pages : 400

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Book Description
Surgical skill and imaging technology in the field of neurosurgery have developed remarkably during the past decade. Magnetic resonance imaging (MRI), with high contrast resolution and multiplanar capabilities, allows for accurate preoperative localization and postoperative assessment of syringomyelia. Recent advances in dynamic MRI techniques have made it possible to evaluate normal and abnormal cerebrospinal fluid (CSF) flow at the foramen magnum, within the syrinx, and in the spinal subarachnoid space, without invasion of the closed CSF system. These developments have yielded substantial information concerning various aspects of syringomyelia. However, many issues related to the pathophysiology and treatment of syringomyelia remain controversial. This book contains the scientific contributions presented at the international sym posium "Syringomyelia 2000:' held in Kobe, Japan, June 16-17,2000. The purpose of the symposium was to bring together experts in the fields of neurosurgery, neurol ogy, and neuropathology, in order to enhance the level and scope of their knowledge by making them more aware of work done in complementary fields. The contribu tions also report on clinical and basic studies pertinent to the topic of the sympo sium. This volume thus represents a comprehensive description of the state of the art regarding this disease in the hope that it may help to define comprehensively what is already known and to find new ways toward a better understanding of the patho physiology, diagnosis, and treatment of syringomyelia.

Author: Marcus Drake
Publisher: John Wiley & Sons
ISBN: 1118844718
Category : Medical
Languages : en
Pages : 230

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Book Description
Abrams’ Urodynamics A complete guide to urodynamic investigation in modern health care Urodynamic testing is an ever-advancing field with applications in the management of patients from across a wide range of clinical areas. Bringing together fundamental principles and cutting-edge innovations, Abrams’ Urodynamics has been designed as an all-in-one guide to Functional Urology and Urogynecology, offering direct, up-to-date instruction on how to best perform and understand urodynamic tests within the overall treatment pathway. Its chapters cover everything from everyday basic practice to advanced complex cases, and are enhanced with more than 450 helpful illustrations. Including numerous revisions and new features, this fourth edition of the book boasts: Coverage of all investigative approaches, including uroflowmetry, cystometry, video-urodynamics, and non-invasive techniques Details on the successful running of a urodynamic unit, with information on organizational issues, equipment set-up, and common problems and pitfalls Sections addressing children, women, men, the elderly, and neuropaths Extensive description of International Continence Society (ICS) Standards throughout Appendices that include ICS Standards and Fundamentals documents, ICIQ modules, and Patient Information Leaflets With its wealth of clinical tips, illustrations, new innovations, and hands-on advice, Abrams’ Urodynamics is essential reading for all those wishing to better integrate urodynamic testing into their daily practice.

Author: Kenneth F. Swaiman
Publisher: Elsevier Health Sciences
ISBN: 0323033652
Category : Medical
Languages : en
Pages : 2535

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Book Description
This Gold Standard in clinical child neurology presents the entire specialty in the most comprehensive, authoritative, and clearly written fashion. Its clinical focus, along with relevant science, throughout is directed at both the experienced clinician and the physician in training. New editor, Dr. Ferriero brings expertise in neonatal neurology to the Fourth Edition. New chapters: Pathophysiology of Hypoxic Ischemic Encephalopathy, Congenital Disorders of Glycosylation, Pediatric Neurotransmitter Diseases, Neurophysiology of Epilepsy, Genetics of Epilepsy, Pediatric Neurorehabilitation Medicine, Neuropsychopharmacology, Pain and Palliative Care Management, Ethical Issues in Child Neurology