Human brain Anatomy and Physiology

Spina Bifida is a neural tube defect (NTD) where the spinal cord is exposed at birth and is often leaking cerebrospinal fluid (CSF). There are two types of Chiari malformation. Both types occur in the bottom of the brain stem where the brain and spinal cord join. The lowest portion of the brain is displaced and is lower than normal pushing down into the spinal column.

At the level of each vertebra in the spine, nerve fibers arise from the spinal cord and emerge through openings between the vertebrae. These are the spinal nerves, which carry messages to and from various regions of our bod­ies. (About Hydrocephalus, 2011)

The brain consists of four main structures: the Cerebrum, the Cerebellum, the Pons, and the Medulla.

The Cerebrum is the upper part of the brain and is arranged in two hemispheres called cerebral hemispheres. The cerebrum is thought to control conscious mental processes. The outer layer of the cerebrum is called gray matter, the inner portion, white matter.

We often hear the terms “gray matter” and “white matter” in radiology reports or when viewing scans with our neurosurgeons. Grade III and IV intraventicular hemorrhages (IVH) as well as periventricular leucomalacia (PVL) can cause damage to the brain tissue, and can lead to hydrocephalus.

The cerebral hemispheres are divided into four sections or lobes: the frontal lobe, responsible for thinking, making judgments, planning, decision-making and conscious emotions, the Parietal Lobe, mainly associated with spatial computation, body orientation and attention, the Temporal Lobe, concerned with hearing, language and memory, and the Occipital Lobe, mainly dedicated to visual processing.

The key features of the Dandy Walker syndrome are an enlargement of the fourth ventricle, a partial or complete absence of the area of the brain between the two cerebellar hemispheres and cyst formation near the lowest part of the skull. Approximately 70 to 90 percent of patients have hydrocephalus.

The Cerebellum is the part of the brain located between the brain stem and the back of the cerebrum. The cerebellum controls muscle coordination and maintains bodily equilibrium.

An increase in cerebrospinal fluid (CSF) in the fourth ventricle can put pressure on the lobe of the cerebellum (hindbrain). Compression of this lobe can cause gait, balance and postural problems.

The Pons is in front of the cerebellum and coordinates the activities of the cerebrum and the cerebellum by receiving and sending impulses from them to the spinal cord.

The Medulla is part of the brainstem situated between the pons and the spinal cord and it controls breathing, heartbeat, and vomiting.

There are many other anatomical features of the brain which specialize in various activities. The Meninges consist of three membranes which cover the brain and spinal cord including the dura mater, the arachnoid membrane and the pia mater. They completely surround the brain and spinal cord.

Hydrocephalus produces pressure on the meninges which in turn can increase pressure on the optic nerve causing vision problems.

Cerebrospinal fluid flows in the space between two of the layers in a space called the subarachnoid space. CSF is essentially salt water, and it is in constant circulation and serves several important functions. The brain floats in CSF.

Subarachnoid hemorrhage is a bleeding in the subarachnoid space. Acute hydrocephalus is present in 20 percent of patients with subarachnoid hemorrhage.

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