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AAP Grand Rounds 11:43-44 (2004)
© 2004 American Academy of Pediatrics
| The first 20% of the full text of this article appears below. |
The recognition that dietary folic acid supplementation can greatly reduce the risk of open neural tube defects (NTDs) is one of the most gratifying developments in preventive medicine and public health in recent decades.1 The open NTDs, anencephaly and myelomeningocele, represent the most severe end of the spectrum of developmental central nervous system anomalies that include encephaloceles, cranial and spinal meningoceles, cranial and spinal dermal sinus tracts, split cord malformation (also known as "diastematomyelia"), tight filum terminale, lipoma of the filum terminale, and lipomyelomeningocele (LMM). The embryopathogenesis of these latter entities is not well understood but, like the open NTDs, they are presumed to be caused by some disturbance of neural tube closure.
In the past, a family history of any one of these entities has been presumed to similarly affect the risk in subsequent offspring of all of the other entities. Only recently has this assumption
| Neurological Surgery and Pediatrics, Drexel University College of Medicine, St. Christophers Hospital for Children, Philadelphia, PA |
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