Ali Raza Brohi, Shams Raza Brohi, Muhammed Saleh Khaskheli.
Pattern and frequency of cranio-spinal anomalies.
J Surg Pak Jan ;13(2):67-70.

Objective: To find out number and type of cranio-spinal anomalies and management given. Study Design: Observational study Place and Duration of study: Department of Paediatric Surgery and Neurosurgery at Nawabshah Medical College Nawabshah, from January 2006 to December 2007. Patients and Methods: All patients with gross CNS anomalies were included in this study. Data related to type of anomaly, gender, age, location etc were recorded on a pre-designed proforma. Parents were counseled regarding prospects of survival, operative procedure and the quality of life. Genetic and family planning advice were given. Those who were considered candidate for surgery were investigated using ultrasound and CT scan according to the type of lesion. Results: A total of sixty four patients were received during the study period. Males were in dominance (n – 40 62.5%) and most of them belonged to rural areas. Fifty two cases (81.25%) were operated and 12 cases (19.75%) were managed conservatively. The most common anomaly was isolated hydrocephalus (n-27) followed by menenigocle and myelomeningocele (n-17). Both lesions combined found in 7 patients. None of the mothers had folic acid supplementation before conception. Conclusions: Patients with gross major CNS defects and associated with systemic problems do not need active surgical intervention. Patients with amenable neural tube defect and expected of adequate quality of life require operation after proper counseling. There is a need of public awareness of folic acid supplementation in the antenatal period and antenatal screening.

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