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Neural tube defects (NTDs) are variety of defects which result from abnormal closure of the neural tube during embryogenesis. Various factors are implicated in the genesis of neural tube defects, with contributions from both genetic and environmental factors. The clear understanding of the causes which leads to NTDs is lacking, but several non-gene...
Context in source publication
Context 1
... fusion begins in cervical region and proceeds in cranial and caudal directions. Ends of the neural tube, neural pore, are closed first on the cranial side (21 days post fertilization) followed by the caudal side (28 days post fertilization) (Figure 3). Thus, neurulation is a process involved in the formation of neural tube and closure of neuropores by the end of the fourth week of embryo development [2,3]. ...
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Background
Folic acid (FA) supplementation is associated with a lower risk of the neural tube and heart defects and is recommended for women of childbearing age. Although there are detailed recommendations, differences in the initiation time and duration of FA supplementation remain poorly studied.
Methods
A multicentre prospective study of 17,713...
Citations
... Because the two edges of the primitive neural plate are continuous with the embryonic cutaneous ectoderm, successful dorsal closure of the primary neural tube also ensures perfect fusion of the midline skin and mesodermal tissues. (4,10) Complete failure of primary closure of the neural tube results in an open skin defect and an exposed, unfused neural plate, which is called an open neural tube defect. (4) This incomplete closure generally leads to a malformation characterized clinically by neurogenic bladder and bowel dysfunction, as well as varying degrees of distal weakness. ...
Introduction: Myelomeningocele is the most common form of spinal
dysraphism. In the African context, late diagnosis and surgical treatment are
frequent.
Objective: To characterize an initial series of open myelomeningocele cases
that received delayed repair at the Hôpital de Référence de Maradi.
Methods: A series of five cases is presented, with open myelomeningocele,
who received delayed surgical repair at the Hôpital de Référence de Maradi,
Niger, between June - December 2022. The information was obtained from
medical records and imaging records.
Results: Five patients were intervened, three female and two male. In all
cases the age of the patients at the time of surgery was greater than 30 days.
All the dysraphisms were open, showing signs of partial or total
epithelialization of the placode, at the time of the intervention. During the
evaluation of neurological function, three of them exhibited distal paraplegia, with reflex and sphincter involvement. Laboratory tests showed, in all cases,
hemoglobin levels below 12 mg/dl. None of the cases showed deterioration of
the neurological state with respect to the preoperative evaluation.
Conclusions: The surgical treatment of myelomeningocele in a low-resource
setting, as is common in sub-Saharan Africa, has its own characteristics,
marked by late presentation to specialized hospital centers, and the low
nutritional status of patients. Surgical resection, partial or total, of an
exposed and devitalized placode, with signs of epitalization, does not seem to
influence the postoperative neurological status.
Neural tube defects (NTDs) represent a developmental disorder of the nervous system that can lead to significant disability in children and impose substantial social burdens. Valproic acid (VPA), a widely prescribed first-line antiepileptic drug for epilepsy and various neurological conditions, has been associated with a 4-fold increase in the risk of NTDs when used during pregnancy. Consequently, urgent efforts are required to identify innovative prevention and treatment approaches for VPA-induced NTDs. Studies have demonstrated that the disruption in the delicate balance between cell proliferation and apoptosis is a crucial factor contributing to NTDs induced by VPA. Encouragingly, our current data reveal that melatonin (MT) significantly inhibits apoptosis while promoting the restoration of neuroepithelial cell proliferation impaired by VPA. Moreover, further investigations demonstrate that MT substantially reduces the incidence of neural tube malformations resulted from VPA exposure, primarily by suppressing apoptosis through the modulation of intracellular reactive oxygen species levels. In addition, the Src/PI3K/ERK signaling pathway appears to play a pivotal role in VPA-induced NTDs, with significant inhibition observed in the affected samples. Notably, MT treatment successfully reinstates Src/PI3K/ERK signaling, thereby offering a potential underlying mechanism for the protective effects of MT against VPA-induced NTDs. In summary, our current study substantiates the considerable protective potential of MT in mitigating VPA-triggered NTDs, thereby offering valuable strategies for the clinical management of VPA-related birth defects.
Desde la visión de los autores, no es probable que una placa neural expuesta y desvitalizada, siga preservando una funcionalidad neurológica útil, y las complicaciones derivadas de su preservación podrían superar los posibles beneficios. Sin embargo, la evidencia es aún inicial. Consideramos que este subgrupo de casos, tan frecuente en regiones desfavorecidas como el continente africano, merece un tratamiento quirúrgico diferenciado, como resultado de estudios más amplios y alejado de algoritmos diseñados para entornos con mayor disponibilidad de recursos. Los pasos iniciales en este sentido son alentadores.
