The Prevalence of Chiari II Malformation in Neonates with Myelomeningocele at Ayub Teaching Hospital, KPK

Ehtisham Ahmed khan Afridi, Muhammad Waleed Khan, Shabana Naz, Saadia Maqbool, Aqsa Shehzadi, Nusrat Shaheen
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Abstract

Objective:  Neural tube defects (NTDs) are common in northern areas of Khyber Pakhtunkhwa (KPK) and need a lot of community education for the parents regarding this disease, which impaired the patients for their whole life. The study aimed to assess the contribution of a family history of myelomeningocele and the resulting incidence of Chiari II malformation. Materials and Methods:  A total of 131 patients were observed to determine the frequency of the Chiari II malformation in patients with myelomeningocele who presented in Ayub Teaching Hospital, Abbottabad. All neonates were sent to the radiology department for MRI. A repair procedure for meningomyelocele was done. Results:  The mean age was 16.56 days. In 53.4% of neonates, there was a familial history of spinal dysraphism, while in 46.6% there was no familial history. Chiari II malformation was present in 23.7% of patients who presented with myelomeningocele. A significant difference (p-value < 0.00001) existed between the presence/absence of a family history of myelomeningocele and Chiari II malformation out of the total. Conclusion:  Early surgery, along with a multidisciplinary approach, provides the best opportunity for improved results and survival. Keywords:  Meningomyelocele, Neural Tissue, Maternal Folate Intake, Meningomyelocele (MMC) Repair.
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KPK Ayub教学医院新生儿脊髓脊膜膨出中Chiari II型畸形的患病率
目的:神经管缺损在开伯尔-普赫图赫瓦省北部地区较为常见,需要对神经管缺损的家长进行大量的社区教育,使患者终身受损。该研究旨在评估脊髓脊膜膨出家族史的贡献和由此导致的Chiari II型畸形的发生率。材料和方法:在阿伯塔巴德的Ayub教学医院共观察了131例脊髓脊膜膨出患者中Chiari II型畸形的发生率。所有新生儿均送往放射科进行MRI检查。行脑脊膜膨出修复术。结果:平均年龄16.56 d。53.4%的新生儿有脊柱发育异常家族史,46.6%的新生儿无脊柱发育异常家族史。23.7%的脊髓脊膜膨出患者存在Chiari II型畸形。有/没有脊髓脊膜膨出家族史和Chiari II型畸形之间存在显著差异(p值< 0.00001)。结论:早期手术配合多学科方法,为改善预后和生存率提供了最好的机会。关键词:脑脊膜膨出,神经组织,母体叶酸摄入,脑脊膜膨出修复
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