New Delhi (FoC): Today, 25th October 2018,  is World Spina bifida and Hydrocephalus Day. It is a new social engagements by international health care bodies since last six year to familiarize public and Official for a disease spectrum that has not been addressed so efficiently as it should.

GB Pant hospital organized the meeting in its auditorium with its patients and care giver.Dr Manish goel informed about prevailing problems in Spina bifida and highlighted the role of risk factors such as sindoor, deficiency of folic acid, antiepileptic drugs in genesis of spina fifida.

There are several congenital disorders in the body. It affects almost all parts of human body including heart, genital organs,musculoskeletal organs and brain. In the central nervous system, some of the common congenital diseases include hydrocephalus, agenesis of corpus callosum, various brain cysts ,Chiary malformations and others.

Hydrocephalus is perhaps the most common Brain congenital disease which is prevalent all over world. The incidence is some what 80-330/100000 live birth. In India,incidence is around 110-120/100000.It means There could be a large burdon of this condition with unknown actual figures.

The maximum incidence is in Latin America and African subcontinent. According to one estimate , there are almost 400000 of new cases of hydrocephalus diagnosed world wide.This fissure is much more than persons suffering from HIV per year. Despite being higher number , it is not adequately being addressed by Health policies for its diagnosis and treatment.

Hydrocephalus is a condition wherein the water in the brain is more than normal and is associated with series of complex neurological symptoms. It can lead to enlargement of head, eyes deviation (sun set sign) and delayed milestone in children less than one year. Older patient can have headache ,vomiting, and even blindness.

Together Spina bifida and hydrocephalus may be the maximum numbers of congenital disorder a compared to any other part of the body informed DR daljit Singh Head Neuro surgery GIPMER Delhi.

In elderly paerson it presents as Normal pressure hydrocephalus (NPH) which can lead to symptoms which mimic Alzeimer disease,Dementia and may be wrongly diagnosed so. With increasing survival of Indian population, we are getting more and more of such cases every year for operations.

Genetic Cause o hydrocephalus is also proposed due to LICAM and other genes. It is X linked disorder which is transmitted to children and can affect families. Foetal hydrocephalus can be picked up during pregnancy and its treatment can be difficult and challenging. It ha some ethical issues in its management as most of hydrocephalus which during pregnancy are confirmed at 28-32 weeks when therapeutic abortion is legally not permitted.

Major cause of hydrocephalus in India is infection of which tuberculosis is the leading etiology in any age but more so in children. Aqueduct stenosis is another common condition associated with hydrocephalus.

Diagnosis is done using ultrasound or CT scan. MRI is more informative particularly for surgical decisions.

For its treatment, V P shunt tube which delivers water from brain to abdomen is inserted with excellent results. Shunt has its own limitation so endoscopic treatment for hydrocephalus can provide shunt free life and better acceptance.

Neural tube defect is another major congenital condition which develop during 28 to 32 days of pregnancy. Some time defects has already there before a female comes to know that she is pregnant and that creates a major problem. Folic acid is given during pregnancy to prevent its genesis and hence is a part of national program for maternal and child health.

Some of the major form of NTD are incompatible with life and get aborted or may have intrauterine deaths. Others can be diagnosed during pregnancy itself.

Spina bifida can be associated with problems elsewhere in the body beside back of the spine. There can b club foot , Chiary malformation, syringomyelia, and problems of genitourinary system.

Children are born with swelling in back or some stigmata such a fat,hair,naevus,dimple and these may be sentinel to underlying spinal bifida, where lamina of spine failed to fuse in midline.

Some of these kids may present neulogical problems in later part of life, or even non healing ulcers in legs

MRI and CT scan are mainstay in diagnosis and planning surgery.

Surgery is the only remedy and can yield good results in most of the cases. It also require assistance of physiotherapist, urologist, plastic surgeons, Orthopedicians and pediatrician to manage these case holistically.

Psuchological support to patein care members is done with the help of expert and specific remedial options are available with encouraging results.Dr Manish from IHBHAS clinical psychologist told the children with hydrocephalus have a special learning and attension deficit and can pose challenge in its management .

Unfortunately no definite National level program in India have yet materialized to look into the plights of early pickup and screening of high risk cases of congenital brain disorder.