An open access, multimedia website about surgical illnesses found in the nervous system of children and their management
Congenital Disorders of the Nervous System in Children
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Editor In Chief:
Embryology of the Central Nervous System in Children Homepage
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Introduction
During the first 4 weeks after fertilization, the CNS of the embryo undergoes a series of morphological and structural changes that result in the formation of the neural tube (brain and spinal cord). These can be divided into four phases: 1) blastogenesis, 2) gastrulation, 3) primary neurulation, and 4) secondary neurulation. Once neural tube formation is completed, a series of additional morphological changes occurs within the brain and spinal cord, divided into four additional phases: 1) ascent of the conus medullaris, 2) development of the cranial vesicles and flexures, 3) formation of the basal and alar plates and their derivatives, and 4) migration of neuronal and glial cells. Each of these processes will be summarized in this chapter. The term “postovulatory day” (POD) will be used to describe the phase or gestational age of the embryo; this designation is used in standard embryology studies to describe human embryonic development.
Key Points
- Gastrulation – conversion of two-layer to three-layer embryo: Gastrulation results in conversion of a two-layered embryo, containing epiblast and hypoblast, to a three-layered embryo, containing ectoderm, mesoderm, and endoderm.
- Primary neurulation – CNS formation to S2: Primary neurulation results in formation of the brain and spinal cord as far caudal as the second sacral segment (S2) and separation (dysjunction) of the cutaneous ectoderm from the neuroectoderm.
- Secondary neurulation – cord formation distal to S2: Secondary neurulation forms the spinal cord caudal to S2 and the filum terminale from a different embryonic mechanism.
- Ascent of conus to L1-L2: Ascent of the conus medullaris results in the tip of the conus lying most commonly opposite the L1-L2 disk space; a conus below the mid-body of L2 is tethered radiographically.
- Vesicle and flexure formation shapes brain: The formation of the primary and secondary vesicles and three flexures contributes to the ultimate shape and structure of the brain.
- Neuronal migration region specific: Neuronal migration occurs in a specified pattern from basal and alar plate neurons, a process that is modified somewhat within each regional level of the neuraxis.
More
Infections of the Nervous System in Children
Functional Disorders of the Nervous System in Children
Section Editors
Sanjiv Bhatia, M.D.
William Harkness, M.D.
Editor-in-Chief
Rick Abbott, M.D.
Spinal Diseases and Anomalies in Children
Vascular Disorders of the Nervous System in Children
Section Editors
Takayuki Inagaki, M.D.
Editor in Chief
Rick Abbott, M.D.
Tumors of the Nervous System in Children
Acknowledgements
Editor-in-Chief
| Rick Abbott, M.D.
Director, Surgical Neuro-oncology, Children’s Hospital at Montefiore Professor Neurosurgery and Pediatrics, Albert Einstein College of Medicine Department of Neurosurgery, Montefiore Medical Center 111 E. 210th St Bronx, NY 10467 USA
Phone: 001 718 920-8512 Email: rickabbott@me.com Website: http://www.montekids.org/services/neurosurgery/physicians/abbott/ |
Senior Editor
| Ann Ritter, M.D.
Associate Professor Virginia Commonwealth University 417 North 11th St, 6th Floor Richmond, VA 23298 USA
Phone: 804-828-9165 Email: aritter@mcvh-vcu.edu |
Publication Manager
| Zulma Tovar-Spinoza, M.D.
Assistant Professor of Neurosurgery SUNY Upstate Medical University 750 E Adams St 604 Jacobsen Hall Syracuse, NY USA
Phone: 001 315 464-4418 Website: www.upstate.edu/neurosurgery Linkedin: Zulma Tovar-Spinoza |
Section Editors
| Douglas Brockmeyer, M.D.
Chief of Pediatric Neurosurgery Professor of Neurosurgery, Adjunct Professor of Pediatrics University of Utah Primary Children’s Hospital Pediatric Neurosurgery 100 N Mario Capecchi Drive Salt Lake City, UT 84113 USA
enkode|douglas.brockmeyer@hsc.utah.edu |
| Adrian Caceres, M.D.
Associate Professor in Neurosurgery and Pediatric Surgery, University of Costa Rica. National Children´s Hospital of Costa Rica. Paseo ColĂłn y Calle 20 sur Servicio NeurocirugĂa 4 piso San JosĂ© Costa Rica
Phone: 011 506 25233600 Ext. 4519,4520 Email: neuroqx@gmail.com Skype: Adrian.caceres.chacon.1 Website: www.icneuro.com Linkedin: Adrian Caceres |
| Oguz Cataltepe, M.D.
Director, Pediatric Neurosurgery University of Massachusetts Memorial Medical Center 55 Lake Avenue North, S2-848 Worchester, MA 02493 USA
Phone: 001 508 334-7667 |
| Shlomi Constantini, M.D.
Pediatric Neurosurgery Dana Children’s Hospital, Tel-Aviv Medical Center 6, Weizman Street Tel Aviv 62439 Israel
Email: sconsts@netvision.net.il |
| Graham Fieggen, M.D.
Division of Neurosurgery Groote Schuur Hospital Old Main Building Main Road Observatory Cape Town 7925 South Africa
Email: graham.fieggen@uct.ac.za |
| Bermans J. Iskandar, M.D.
Director Pediatric Neurosurgery Professor of Neurosurgery and Pediatrics University of Wisconsin Hospital and Clinics, Department of Neurosurgery Madison, WI 53792 USA
Phone: 001 608 263-9651 Email: iskandar@neurosurg.wisc.edu |
| David Sandberg, M.D., FAANS, FACS, FAAP
Associate Professor University of Texas Health Science Center at Houston, Children’s Memorial Hermann Hospital, and the University of Texas MD Anderson Cancer Center 6431 Fannin Street, MSB#5.144 Houston, Texas USA
Phone: 001-713-500-7370 Email: David.I.Sandberg@uth.tmc.edu |
| Paul Steinbok, M.B.B.S., FRCSC
Professor British Columbia’s Children’s Hospital and University of British Columbia 4480 Oak St, K3-159 Vancouver, BC Canada
Phone: 001-604-875-2094 Email: psteinbok@cw.bc.ca |
| Edward R. Smith, M.D.
Associate Professor Harvard Medical School Director, Pediatric Cerebrovascular Surgery Department of Neurosurgery / Vascular Biology Program Children’s Hospital Boston / Harvard Medical School 300 Lonwood Ave. Boston, MA 02115 USA
Phone: 001=617-355-8414 |
| Gianpiero Tamburrini, M.D.
Associate Professor Pediatric Nerosurgery Institue of neurosurgery Catholic University Medical School Largo Agostino Gemelli, 8 Rome 00168 Italy
Phone: 390630155925 Email: gianpiero.tamburrini67@gmail.com Linkedin: Gianpiero.Tamburrini |
| Dominic Thompson, MBBS BSc FRCS(SN)
Honorary Senior Lecturer Great Ormond Street Hospital Institute for Child Health Great Ormond Street Department of Paediatric neurosurgery London, WC1N 3JH United Kingdom |
Manuscript Editor
| Arlene Stolper Simon, M.B.A.
200 East 90th Street Apt. No: 27E New York, NY 10128 USA
001-212-987-6556 |
Assistant Editors – Website Composition
| Andrew Kobets, M.D.
Resident, Department of Neurosurgery Albert Einstein College of Medicine Montefiore Medical Center 111 E. 210th St Bronx, NY 10467 USA
Email: ajkobets@yahoo.com |
| Kara Weber, B.S.
901 East River Parkway City: Minneapolis, MN, 55414 USA
Email: webe0499@umn.edu Linkedin: Kara Weber |
Authors
| Varun Badami, B.S., B.A. |
| Arundhati Biswas, M.D., MS, MCh, DNB
Resident, Department of Neurosurgery Albert Einstein College of Medicine Montefiore Medical Center 111 E. 210th St Bronx, NY 10467 USA
Email: abiswas@montefiore.org |
| Thomas Beez, M.D.
Department of Neurosurgery Medical Faculty Heinrich-Heine-University Moorenstrasse 5 Duesseldorf 40224 Germany
|
| Ira Bowen, B.A. |
| Sandip Chatterjee, MBBS,DNB(SURG),FRCS(SN),MNAMS(Neurosurg).
Professor And Head Department Neurosurgery VIMS 4 Gorky Terrace Kolkata, West Bengal, 700017 India
913322800758 |
| David Chesler, M.D., Ph.D.
Fellow The Johns Hopkins Hospital Division of Pediatric Neurosurgery Phipps 579 600 N Wolfe St. Baltimore, MD, 21287 USA
Phone: 001 410 955-7882 Email: dchesle2@jhmi.edu |
| Chandrashekhar E. Deopujari, M.Ch.
Professor Neurosurgery Bombay Hospital & Institute of Medical Sciences Room 126 B, 1st Floor, Medical Research Centre19, New Marine Lines, Mumbai 400020 India |
| Sandrine de Ribaupierre, M.D., MSc
Associate Professor University of Western Ontario Victoria Hospital – 800 Commissioners Rd E #:B1-181 London, Ontario N6C 5W9 Canada
Phone: 001-519-685-8107 Email: Sandrine.deRibaupierre@lhsc.on.ca Website: http://www.cnsuwo.ca/faculty/neurosurgeons/sandrine-de-ribaupierre/ |
| Mark Dias, M.D. |
| Roberto Jose Diaz, M.D., Ph.D.
Resident, Division of Neurosurgery University of Calgary Foothills Medical Centre 12th Floor – 1403 29th St NW Calagary, Alberta Canada T2N 2T9
Email: rjdiaz@ucalgary.ca |
| James Drake B.S., M.B.B.Ch. Medicine, MSc
Professor Sick Kids Hospital, University of Toronto 555 University Avenue Toronto, Ontario Canada
Email: James.Drake@sickkids.ca |
| Mostada El Khashab, M.D.
Pediatric Neurosurgery Hackensack University Medical Center 20 Prospect Avenue Suite 905 Hackensack, NJ 07601 United States |
| Volkan Etus, MD
Professor Department of Neurosurgery, Kocaeli University Faculty of Medicine 41380, Umuttepe Campus, Izmit Kocaeli Turkey
Phone: 0090 262 303 7232 Email: volkanetus@yahoo.com Website: www.kocaeli.edu.tr/int Linkedin: Volkan Etus |
| Herbert Fuchs, M.D., Ph.D.
Associate Professor of Surgery, Division of Neurosurgery Duke University Medical Center Box 3272 DUMC Durham, NC USA
Phone: 001 919 681-0894 Email: herbert.fuchs@duke.edu |
| Kemel Ahmed Ghotme, M.D.
Servicio de NeurocirugĂa ClĂnica Universitaria TeletĂłn Autopista Norte, Km. 21 ChĂa Cundinamarca 00 Colombia |
| Keith Goh, MBBS, FRCSEd, FCSHK, FHKAM, FAMS
Senior Consultant Neurosurgeon Mount Elizabeth Hospital, Singapore 3 Mount Elizabeth, 09-10 Mount Elizabeth Medical Centre Singapore Singapore
Phone: +65 62350945 |
| Daniel Guillaume, M.D. |
| Ajit Jada, M.D.
Resident, Department of Neurosurgery Albert Einstein College of Medicine Montefiore Medical Center 3316 Rochambeau Avenue Department of Neurosurgery Bronx, NY 10467 USA
Phone: 718-920-7400 |
| George Jallo, M.D.
Neurosurgery Johns Hopkins University 600 North Wolfe Street Harvey 811 Baltimore, MD 21093 USA |
| Andrew Jea, M.D.
Associate Professor (with Tenure) Baylor College of Medicine Texas Children’s Hospital 6621 Fannin Street, CCC 1230.01 Houston, TX USA
Phone: 001 832 822-1289, 001 832 822-3950 |
| Mark D. Krieger, M.D.
Division of Neurosurgery CHLA 1300 N Vermont Ave Suite 1006 Los Angeles, CA 90027 USA |
| Abhaya V. Kulkarni, MD, PhD, FRCSC
Associate Professor, Division of Neurosurgery Program Director, Neurosurgery University of Toronto Hospital for Sick Children 555 University Avenue Toronto, Ontario, Canada M5G 1X8
Phone: 416-813-6427 |
| Subash Lohani, MBBS
Medical Officer National Institute of Neurological and Allied Science P.O. Box No. 3711 Bansbari, Kathmandu Nepal
Mobile Phone: +977-9841457781 |
| Juan F. MartĂnez-Lage, M.D.
Associate Professor of Neurosurgery Virgen de la Arrixaca University Hospital Ave. Alfonso X el Sabio 14 Murcia Spain
Phone: 34 968 369 489 |
| Luca Massimi, M.D., Ph.D.
Assistant Professor A. Gemelli Hospital, Catholic University Medical School Largo A. Gemelli, 8 via Barbiellini Amidei, 44, 00168 Rome Italy
Phone: +39 0630154587 |
| John S. Myseros, M.D.
Associate Professor Children’s National Medical Center 111 Michigan Avenue, NW Suite 4W-100 Washington, DC 20010 USA
Phone: 001-202-476-5320 Website: www.childrensnational.org |
| Farideh Nejat, M.D.
Professor Head of Pediatric Neurosurgery, Tehran Univesity Medical Sciences Children’s Medical Center Keshavarz Bulvard, Gharib street,Children Medical Center Jalal Al Ahmad , Parvaneh Street, Number 6, Unit 4 Tehran Iran
Phone: (98) 21 88016835 Email: nejat@sina.tums.ac.ir |
| W. Jerry Oakes, M.D.
Chief Pediatric Neurosurgery Professor Children’s of Alabama, Birmingham, AL Lowder 400 1600 7th Ave South Pediatric Neurosurgery Birmingham, AL 35233 USA |
| Greg Olavarria, M.D.
Arnold Palmer Hospital for Children 1222 South Orange Ave, 2nd Floor Orlando, FL USA
Phone: 001 321 841 3539 |
| Mark Proctor, M.D.
Associate Professor Boston Children’s Hospital/ Harvard Medical School 300 Longwood Avenue Boston, MA 02115 USA
Phone: 617-355-2403 |
| Benedict Rilliet, M.D.
Service de Neurochirurgie HĂ´pitaux Universitaires, Geneva 3-4 rue Gabrielle Perret Gentil Geneva Canton de Geneve 1211, Geneva 14 Switzerland |
| Francisco Salomao, M.D.
Department of Surgery – Section of Pediatric Neurosurgery Instituto Fernandes Figueira – Fundação Oswaldo Cruz (IFF-Fiocruz) Av. NS Copacabana, 749/604 Rio de Janeiro Rio de Janeiro 22050-020 Brazil |
| Adam Sandler, M.D.
Resident, Department of Neurosurgery Albert Einstein College of Medicine Montefiore Medical Center 111 E 210th St Bronx, NY 10467 USA
Phone: 001 718 920-7400 |
| Carolina Sandoval-Garcia, M.D.
Resident, Department of Neurosurgery University of Wisconsin Dept of Neurosurgeyr, K4/822 University of Wisconsin Hospital and Clinics, Department of Neurosurgery Madison, WI 53792 USA
|
| Spyros Sgouros, M.D.
Pediatric Neurosurgery “Mitera” Childrens Hospital Kifisias Avenue & Erythrou Stavrou 6 Marousi Athens Attiki 151 23 Greece |
| Ash Singhal, M.D.
Neurosurgery British Columbia Children’s Hospital 4480 Oak Street Vancouver, BC v6s 1n1 Canada |
| Jodi L. Smith, Ph.D., M.D., FAANS
John E. Kalsbeck Professor and Director of Pediatric Neurosurgery Riley Hospital for Children at Indiana University Health Associate Professor of Neurological Surgery Indiana University School of Medicine 702 Barnhill Drive, STE 1134 Indianapolis, Indiana 46202 USA
Phone: 001 317 274-8852 Website: http://www.goodmancampbell.com/faculty-and-staff.cfm/staff/65 |
| Mark M. Souweidane, M.D. F.A.C.S., F.A.A.P.
Professor of Neurological Surgery Weill Cornell Medical College 525 East 68th Street Box 99 Baker Pavilion Floor 22 Room 2203 New York, NY 10065 USA
Phone: 001 212 746-2363 Website: http://weillcornell.org/physician/mmsouweidane/index.html |
| Â Caleb Standafer, B.S |
| Vassilios Tsitouras, MD
Department of Pediatric Neurosurgery – “Mitera” Children’s Hospital 6, Erythrou Stavrou Street, PC: 151 23 Marousi, Athens Greece
Phone: 0030 210 686 9528 Mobile Phone: 0030 6974 398873 Skype: vatsiskype Linkedin: Vassilis Tsitouras |
| Gary Tye, M.D.
Chief, Pediatric Neurosurgery, Children’s Hospital of Richmond Associate Professor Medical College of Virginia MCV Campus, Ambulatory Care Center 417 North 11th St PO Box 9806 Richmond, VA 23298-0631 USA
Phone: 001 804 828-9165 |
| R. Shane Tubbs MS, PA-C, PhD
Anatomist Professor St. George’s University, Grenada, Children’s of Alabama, Birmingham, AL Lowder 400 1600 7th Ave South Pediatric Neurosurgery Birmingham, AL 35233 USA |
| Frank Van Calenbergh, M.D.
Neurosurgery University Hsopital Leuven Herestraat 49 Leuven Vlaams Brabant 3000 Belgium |
| Â Francisco Villarejo, M.D. |
| Matthieu Vinchon, M.D., Ph.D.
Professor Lille University hospital rue Emile Laine Lille France
Phone: (33)320 44 64 64 |
| Zhiping Zhou, M.D., Ph.D. |
