Anemia of Prematurity - Portal Neonatal

Picture 2. Neural tube defects in the neonatal period. This anteroposterior skull radiograph
demonstrates the craniolacunia or Lückenschädel seen in patients with myelomeningocele and
hydrocephalus. Mesodermal dysplastic changes cause defects in the bone. The thin ovoid areas of
calvaria often are surrounded by dense bone deposits. They are most likely the result of defective
membranous bone formation typical of neural tube defects and not increased intracranial pressure
as once thought. These characteristic honeycomb changes are seen in about 80% of the skulls in
children with myelomeningocele and hydrocephalus.
Picture 3. Neural tube defects in the neonatal period. Sagittal T1-weighted MRI image of a child
after closure of his myelomeningocele. Child is aged 7 years. Note the spinal cord ends in the sacral
region far below the normal level of T12-L1. It is tethered at the point in which the neural placode
was attached to the skin defect during gestation. The MRI showed dorsal tethering, and the child
complained of back pain and had a new foot deformity on examination.
Picture 4. Neural tube defects in the neonatal period. Sagittal T1 MRI image of a child with
a myelomeningocele and associated Chiari II malformation. Note the cerebellar vermis and part of
the brainstem has herniated below the foramen magnum and into the cervical canal (arrow). This
patient had multiple brainstem symptoms and findings to include stridor and cranial nerve paresis
(cranial nerves III, VI, IX, X) despite having a well-functioning ventricular-peritoneal shunt. He
required a posterior fossa decompression of his hindbrain in order to relieve the symptoms of
hindbrain herniation and brainstem compression. Often times, especially in older children, a shunt
revision may alleviate some of the symptoms of hindbrain compression.