As World Hydrocephalous and Spina Bifida Days come up on October 25, neurosurgeons here have urged the Government to embark on national programmes as is being done in many countries to focus on brain congenital conditions like Hydrocephalus (excess fluid in the area around the brain) and Spina Bifida (most common congenital spine defect) which are treatable and results are better when treated early.
"Many countries like the US, Poland and UK have national programmes focusing prevention and awareness about the brain congenital diseases, helping the patients to live a quality life. In contrast, unfortunately no definite national level programme in India have yet materialized to look into the plights of early pickup and screening of high risk cases," said Dr Daljeet Singh, HoD of Neurosurgery at Delhi-based GB Pant Hospital.
He further explained that while there are several congenital disorders in the body, affecting almost all organs including heart, genital organs, musculoskeletal organs, in the central nervous system, some of the common cranial congenital diseases include Hydrocephalus, agenesis of corpus callosum, various brain cysts, Chiary malformations and others.
Of these, Hydrocephalus-- wherein the water in the brain is more than normal and is associated with series of complex neurological symptoms--- is most common cranial congenital disorder found in India. "It can lead to enlargement of head, eyes deviation (sun set sign) and delayed milstone in children less than one year. Older patient can have headache, vomiting, and even blindness, added neurosurgeon Dr AK Srivastava from the hospital.
While world-over, the Hydrocephalus incidence is somewhat 80-330/100,000 live birth, in India it is around 110-120 cases per 100,000. Despite being higher number, it is not adequately being addressed by health policies for its diagnosis and treatment, Dr Srivastava said adding that to create awareness and showcase new medical advances in the sector, Department of Neurosurgery of GB Pant Hospital is organising a public lecture on October 25 at its premises.
"There is currently no known way to prevent or cure hydrocephalus and the only treatment option today requires brain surgery. With early detection and appropriate intervention, most children recover successfully."
However, untreated Hydrocephalus can get worse, leading to brain damage, a loss in mental and physical abilities, and even death.
For its treatment, V P shunt tube which deliver 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, pointed out neurosurgeon Dr Anita Jagetia from the GB Pant Hospital.
Neural tube defects like Spina bifida are another major congenital conditions which develop during pregnancy. "Some time defects is already there before a female comes to know that she is pregnant and that creates a major problem. MRI and CT scan helps in diagnosis and surgery is the only remedy," she added.
Dr Hukum Singh (neurosurgeon) from the Hospital talked about association of Spina bifida with problems elsewhere in the body beside back of the spine. Children are born with swelling in back or some stigmata such as fat, hair, dimple and these may be sentinel to underlying Spinal bifida, where lamina of spine fails to fuse in midline, he explained.
Some of these kids may present neurological problems in later part of life, or even non healing ulcers in legs. However, Folic acid given during pregnancy can help its prevention, said Dr Hukum Singh.