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Updated: Feb 27 2018

CNS Development

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https://upload.medbullets.com/topic/103013/images/meningocele.jpg
  • Overview
    • CNS development (week 3)
      • neuroectoderm (a subtype of ectoderm) → neural plate → brain and spinal cord
    • Neural tube gives rise to
      • forebrain (prosencephalon)
        • telencephalon
          • cerebral cortex, lateral ventricles, caudate, putamen, hippocampus, olfactory bulbs
        • diencephalon
          • thalami, mammillary bodies, neurohypophysis, pineal gland, retina, optic nerve, chiasm, and tract
      • midbrain (mesencephalon)
      • hindbrain (rhombencephalon)
        • metencephalon
          • pons, cerebellum
        • mylencephalon
          • medulla
  • Neural tube defects
    • Failure of neuropores to fuse during week 4
      • vertebral arches do not fuse resulting in a connection between amnionic cavity and spinal canal
      • defect tends to occur in lumbosacral region
      • can be detected by testing maternal blood for ↑ α-fetoprotein (AFP)
        • if elevated and neural tube defect is present, then amniocentesis will show ↑ α-fetoprotein (AFP) and ↑ acetylcholinesterase
      • associated with maternal folate deficiency commonly caused by:
        • low folic acid intake during pregnancy
        • medications that interfere with folate utilization
          • Valproate, methotrexate, sulfasalazine, phenytoin
    • Spina bifida oculta
      • least severe variation with dura intact and no herniation
      • tuft of hair in lumbosacral region
    • Spina bifida with meningocele
      • only meninges herniate through spinal defect forming a CSF filled sac, but spinal cord remains in spinal canal
    • Spina bifida with meningomyelocele
      • meninges and spinal cord herniate through defect
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