The evolution peculiarities of neural axis congenital malformations: clinical case

Abstract

Background: The development of malformation of the Central Nervous System and Spinal Neural Axis are some of the most common congenital malformations of the nervous system, usually with a progressive evolution and require a complex attitude in their management. The aim of the study was to present a clinical case of a patient diagnosed with an abnormality of CNS and of spinal neural axis, associated with active congenital hydrocephalus and spina bifida. Material and methods: a girl with anomaly of CNS and of spinal neural axis, associated with active congenital hydrocephalus and spina bifida was admitted in the Hospital of Mother and Child Health Care in 2019. Results: The malformations were not established during the intrauterine period at the ultrasonic examination. After birth a neurosonography and the cerebral CT determined the active advanced communicating hydrocephaly. Also, it was found spina bifida and erupted thoraco-lumbar meningoradiculocistocel associated with deep paraparesis and sphincterian disorders. The spinal column radiography determined the absence of the vertebral arches, level L1 – S1. Because the hernia bag was broken with CSF eliminations, the patient was taken to be operated in two stages simultaneously, in 24 hours after birth. Under the ultrasonic guidance a ventriculo-peritoneal shunt was applied. The postoperative period followed without particularities with antibiotic therapy. Conclusions: The use in complex of all diagnostic methods led to an adequate, optimal address of both development anomalies. The electroneurography, and the pre-, intra- and postoperative electromyography could be good methods of choice in the diagnosis and treatment of patients with spina bifida.