Anemia of Prematurity - Portal Neonatal

Picture 8. Neural tube defects in the neonatal period. These 2 photographs depict the lumbar
regions on 2 different children with closed neural tube defects. Both children have
lipomyelomeningocele. The child in the left has a dorsal lipoma that is pedunculated. The child on
the right has a more common-appearing lipomatous mass that is heaped up beneath the skin. Both
lipomas lead from the subcutaneous tissue, through the dura and into the intradural space, where
they are attached to the spinal cord. Photos courtesy of Professor J.D. Loeser.
Picture 9. Neural tube defects in the neonatal period. Photograph of a child undergoing a
neurosurgical procedure in which the spinal cord is being detached (untethered) from the intradural
and extradural lipomatous mass that fixes it to the subcutaneous tissue. The white arrow shows the
laser char on the lipoma that has been shaved off the spinal cord and was connected to the
extradural mass. The black arrow shows the extradural lipoma, which crept through the dura and
attached to the spinal cord, thereby firmly fixing the spinal cord at too low and too dorsal a location in
the sagittal plane.
BIBLIOGRAPHY Section 11 of 11
• Adzick NS, Sutton LN, Crombleholme TM, et al: Successful fetal surgery for spina bifida.
Lancet 1998 Nov 21; 352(9141): 1675-6[Medline].
• Aubry MC, Aubry JP, Dommergues M: Sonographic prenatal diagnosis of central nervous
system abnormalities. Childs Nerv Syst 2003 Aug; 19(7-8): 391-402[Medline].
• Bruner JP, Tulipan N, Paschall RL, et al: Fetal surgery for myelomeningocele and the
incidence of shunt-dependent hydrocephalus. JAMA 1999 Nov 17; 282(19): 1819-25.
• CDC: Economic burden of spina bifida--United States, 1980-1990. MMWR Morb Mortal Wkly
Rep 1989 Apr 21; 38(15): 264-7[Medline].
• Charney EB, Weller SC, Sutton LN, et al: Management of the newborn with
myelomeningocele: time for a decision- making process. Pediatrics 1985 Jan; 75(1): 58-
64[Medline].
• Coffey VP: Neural tube defects in Dublin 1953-1954 and 1961-1982. Ir Med J 1983 Oct;
76(10): 411-3[Medline].
• Czeizel AE, Dudas I: Prevention of the first occurrence of neural-tube defects by
periconceptional vitamin supplementation. N Engl J Med 1992 Dec 24; 327(26): 1832-
5[Medline].
• Czyzewski D, Raimondi AJ, et al: Central nervous system infections as a limiting factor in the
intelligence of children with myelomeningocele. Pediatrics 1982; 70: 338-342.
• Harvey MH, Morris BA, McMillan M, et al: Potato steroidal alkaloids and neural tube defects:
serum concentrations fail to demonstrate a causal relation. Hum Toxicol 1986 Jul; 5(4): 249-
53[Medline].
• Hunt GM, Holmes AE: Factors relating to intelligence in treated cases of spina bifida cystica.
Am J Dis Child 1976 Aug; 130(8): 823-7[Medline].