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• W2057004827 abstract "The primitive nervous system begins as a flat neural plate 2 weeks after conception, having arisen from ectoderm. This plate becomes indented by a long­ itudinal groove at 20 days with neural folds on the flanks. These folds begin to fuse in the midline forming a cylinder in the middle of the plate and then in a zipper fashion this dorsal closure is promulgated rostrally and caudally resulting in a tubular structure with an open anterior and posterior aperture corresponding to the anterior and the posterior neuropore. At 26 days the anterior neuropore closes and at 29 days the posterior. Factors necessary for the neural tube formation are intrinsic in the neural ectoderm and adjacent mesoderm. A teratological insult in embryogenesis timed to interfere with the closure of the anterior neuropore will result in anencephalus with failed development of the telencephalic vesicle and the normal cerebral hemispheres are replaced by a mass of undifferen­ tiated cells and abnormal vessels. Anencephalus is responsible for about half of all the neural tube defects and is incompatible with life, and the natural history is for spontaneous abortion, still birth or death shortly after delivery. Failure of closure of the posterior neuropore results in an exposed spinal cord. When this is subjected to intrinsic hydrodynamic forces and extrinsic mechanical and chemical forces of the intrauterine environment, then progressive destruction of the spinal cord occurs, which results in the full panoply of permanent neurological damage and deformity recognised at birth as spina bifida (myelomeningoceoele).l Although it is predominantly a neuro-ectodermal abnormality there is often involvement of adjacent mesodermal structures. The resultant spina bifid a deficit includes life-long handicap from motor and sensory paraplegia, deformity, neuropathic bladder and bowel, Chiari II malformation and hydrocepha­ lus etc, with the extent of the deficit depending predominantly on the pattern and level of spinal cord involvement. Encephalocoeles are traditionally considered as closed neural tube defects but they are probably a" @default.
• W2057004827 created "2016-06-24" @default.
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• W2057004827 date "1996-08-01" @default.
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• W2057004827 title "Folic acid and neural tube defects" @default.
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• W2057004827 doi "https://doi.org/10.1038/sc.1996.79" @default.
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