By Dr. Ravindra Patil
Congenital means present at birth.
These conditions may be mild and without symptoms or may be serious, requiring treatment. In some cases, surgery may be recommended to:
Congenital abnormalities, called malformations, are conditions affecting the form and function of the nervous system. There are numerous variations of congenital malformations of the bone and soft tissue of the head and spine, including neural tube defects, such as spina bifida, encephaloceles, Chiari malformations and arachnoid cysts.
Some congenital malformations are mild, and some are severe but correctable with surgery by a pediatric neurosurgeon.
Types of some of the Congenital Brain and Spine Malformations are as follows:
This is a condition in which portions of the brain, called the cerebellar tonsils, protrude through the bottom opening of the skull into the upper spine, which can put pressure on the brain or spinal cord. Chiari malformations may block the flow of cerebrospinal fluid, leading to hydrocephalus.
Treatments often focus on removing portions of the bone and soft tissue to relieve pressure on the spinal cord and brain, as well as providing new pathways to drain cerebrospinal fluid. Surgeons use different methods for treating these malformations, including decompression, with or without cutting open a small part of the dura mater [thick membrane covering the brain].
Encephaloceles are a type of neural tube defect characterized by the brain being exposed to the outside instead of being covered by the skull and skin. It can lead to infections and hydrocephalus.
Surgical treatment of this condition involves removing bone and soft tissue, draining cerebrospinal fluid, and surgically repairing or closing the encephalocele.
Children who have developed hydrocephalus as a result of an encephalocele will require treatment for that condition, often with a cerebrospinal fluid shunt. Shunting is the placement of a tube into the open area (ventricle) of the brain that allows cerebrospinal fluid to drain to the child’s abdomen or other location where it can be safely reabsorbed into the body.
Arachnoid cysts are the most common type of brain cyst. They are congenital (present at birth) lesions that occur as a result of the splitting of the arachnoid membrane. The cysts are fluid-filled sacs, not tumors, appearing in one of the three layers of tissue covering the central nervous system.
Surgical treatment of this condition involves draining the cyst by drilling a small hole or by opening the skull and making small openings in the cyst to open the natural fluid pathways in the brain. This process is called fenestrating.
A spine deformity occurs when your spine varies by more than 10 degrees from ‘healthy’ curvature. But, what does this mean exactly?
Contrary to popular belief, your spine isn’t 100% straight and vertical. The spinal shape has curvatures, but the end result is that it is vertical! Our spine consists of a series of gentle arcs. Our lumbar spine, or lower back, swoops slightly to the back, and our thoracic spine, or upper back, bends subtly forward. The backward curve of your lower back is known as lordosis and the forward stoop that runs between our shoulder blades is known as kyphosis. Lordosis and kyphosis are spinal curvature deformities. Both are abnormal curvatures of the spine.
But, when viewed head-on, our backbone should look like a straight pillar. Hence, it is also called the ‘vertebral column’.
Moreover, the curves and straight stretches of your spine make symmetry possible. Your head sits directly over your pelvis because the lordosis of your lower back and the kyphosis of your upper spine balance each other out. If one of these curves becomes greater or lesser than the other, then problems can occur. We refer to this as sagittal imbalance, because the head and pelvis no longer fall within the same, or sagittal, plane.
Too much swaying backwards can be thought of as ‘lordosis’, and too much forward stooping in the upper back is ‘kyphosis’.
Likewise, when the spine tilts away from the midline of the body, doctors refer to this problem as coronal imbalance or scoliosis. Unevenness in the ‘coronal’ plane (the view from head-on) causes asymmetry in the trunk of the body. This can include uneven hips and shoulders or one-sided bulging of the ribs.
If a child is born with any of the above malformations, a thorough evaluation by a paediatrician or neurologist is needed to diagnose the problem and recommend a plan for addressing it.
After a thorough physical and detailed family and patient history, your doctor may order imaging of the brain and/or spine through an MRI scan. If the MRI scan shows any evidence of these malformations, a neurosurgical consultation is a must to plan the best treatment.
A multidisciplinary approach is often beneficial for addressing children with congenital brain and spine malformations. Neurosurgeons, craniofacial plastic specialists and geneticists, among others, may be called upon to develop your child’s treatment plan and determine what kind of surgery may be appropriate.
If a congenital brain or spine malformation is mild and not causing any signs or symptoms in your child, the neurosurgeon may recommend observation, which means regular visits and testing to monitor your child’s condition.
If your child does undergo surgery, follow-up care is extremely important in tracking the progress of your child’s recovery. Your paediatric neurosurgeon will schedule follow-up appointments to ensure your child is making the best recovery possible.
Spinal treatments are focused on both correcting the functional shortcomings as well as the structural defects of the spine.
Samarth Neuro and Super Speciality hospital has facilities to surgically treat some of the above brain and spine deformities present since birth. Abnormal curvature of the spine can be corrected to some extent.
Chief Neurosurgeon at Samarth Hospital Dr Ravindra Patil has considerable experience in treating such defects. Besides, as his hospital is located in a tier two city, the cost of treatment is considerably less than in major cities of India. Patients from foreign countries may find going to Miraj for treatment of brain and spine diseases from Dr Ravindra Patil considerably cost effective.
Samarth Neuro and Superspeciality Hospital has 100+ beds & specializes in emergency surgery for neurological issues/disorders & diagnostics.
Samarth Neuro and Superspeciality Hospital
