Physical problems Physical signs of<unk>  may include: * Leg weakness and paralysis * Orthopedic abnormalities (i.e., club foot, hip dislocation, scoliosis) * Bladder and bowel control problems, including incontinence, urinary tract infections, and poor kidney function * Pressure sores and skin irritations * Abnormal eye movement 68% of children with<unk>  have an allergy to latex, ranging from mild to life-threatening. The common use of latex in medical facilities makes this a particularly serious concern. The most common approach to avoid developing an allergy is to avoid contact with latex-containing products such as examination gloves and condoms and catheters that do not specify they are latex-free, and many other products, such as some commonly used by dentists. The<unk> l cord lesion or the scarring due to surgery may result in a tethered<unk> l cord. In some individuals, this causes significant traction and stress on the<unk> l cord and can lead to a worsening of associated paralysis, scoliosis, back pain, and worsening bowel and/or bladder function. Neurological problems Many individuals with<unk>  have an associated abnormality of the cerebellum, called the Arnold Chiari II malformation. In affected individuals, the back portion of the brain is displaced from the back of the skull down into the upper neck. In about 90% of the people with myelomeningocele, hydrocephalus also occurs because the displaced cerebellum interferes with the normal flow of cerebrospinal fluid, causing an excess of the fluid to accumulate. In fact, the cerebellum also tends to be smaller in individuals with<unk> , especially for those with higher lesion levels. The corpus callosum is abnormally developed in 70–90% of individuals with<unk>  myelomeningocele; this affects the communication processes between the left and right brain hemispheres. Further, white matter tracts connecting posterior brain regions with anterior regions appear less organized. White matter tracts between frontal regions have also been found to be impaired. Cortex abnormalities may also be present. For example, frontal regions of the brain tend to be thicker than expected, while posterior and parietal regions are thinner. Thinner sections of the brain are also associated with increased cortical folding. Neurons within the cortex may also be displaced. Executive function Several studies have demonstrated difficulties with executive functions in youth with<unk> , with greater deficits observed in youth with shunted hydrocephalus. Unlike typically developing children, youths with<unk>  do not tend to improve in their executive functioning as they grow older. Specific areas of difficulty in some individuals include planning, organizing, initiating, and working memory. Problem-solving, abstraction, and visual planning may also be impaired. Further, children with<unk>  may have poor cognitive flexibility. Although executive functions are often attributed to the frontal lobes of the brain, individuals with<unk>  have intact frontal lobes; therefore, other areas of the brain may be implicated. Individuals with<unk> , especially those with shunted hydrocephalus, often have attention problems. Children with<unk>  and shunted hydrocephalus have higher rates of ADHD than children without those conditions (31% vs. 17%). Deficits have been observed for selective attention and focused attention, although poor motor speed may contribute to poor scores on tests of attention. Attention deficits may be evident at a very early age, as infants with<unk>  lag behind their peers in orienting to faces. Academic skills Individuals with<unk>  may struggle academically, especially in the subjects of mathematics and reading. In one study, 60% of children with<unk>  were diagnosed with a learning disability. In addition to brain abnormalities directly related to various academic skills, achievement is likely affected by impaired attentional control and executive functioning. Children with<unk>  may perform well in elementary school, but begin to struggle as academic demands increase. Children with<unk>  are more likely than their peers without<unk>  to be dyscalculic. Individuals with<unk>  have demonstrated stable difficulties with arithmetic accuracy and speed, mathematical problem-solving, and general use and understanding of numbers in everyday life. Mathematics difficulties may be directly related to the thinning of the parietal lobes (regions implicated in mathematical functioning) and indirectly associated with deformities of the cerebellum and midbrain that affect other functions involved in mathematical skills. Further, higher numbers of shunt revisions are associated with poorer mathematics abilities. Working memory and inhibitory control deficiencies have been implicated for math difficulties, although visual-spatial difficulties are not likely involved. Early intervention to address mathematics difficulties and associated executive functions is crucial. Individuals with<unk>  tend to have better reading skills than mathematics skills. Children and adults with<unk>  have stronger abilities in reading accuracy than in reading comprehension. Comprehension may be especially impaired for text that requires an abstract synthesis of information rather than a more literal understanding. Individuals with<unk>  may have difficulty with writing due to deficits in fine motor control and working memory.
Spina bifida
Teratoma
Hydranencephaly
Anencephaly
Lissencephaly
Exencephaly
Schizencephaly
Cranioschisis