Acephaly
Acephaly
Acephaly is a rare congenital disorder characterized by the absence of a head. It is a type of cephalic disorder, which is a broader category of conditions involving malformations of the head. Acephaly is a severe form of neural tube defect that occurs during embryonic development.
Pathophysiology
Acephaly results from a failure in the development of the neural tube, which is the precursor to the central nervous system, including the brain and spinal cord. During normal embryogenesis, the neural tube forms and closes, giving rise to the brain and spinal structures. In acephaly, this process is disrupted, leading to the absence of the cranial structures.
The exact cause of acephaly is not well understood, but it is believed to involve a combination of genetic and environmental factors. Research suggests that folic acid deficiency during pregnancy may increase the risk of neural tube defects, including acephaly.
Clinical Presentation
Acephaly is typically diagnosed prenatally through ultrasound imaging. The condition is incompatible with life, as the absence of the brain and cranial structures precludes the possibility of survival outside the womb. In most cases, acephalic fetuses are stillborn or die shortly after birth.
Diagnosis
Prenatal diagnosis of acephaly is usually made during routine ultrasound examinations. The absence of the fetal head is a clear indicator of the condition. In some cases, additional imaging techniques, such as magnetic resonance imaging (MRI), may be used to confirm the diagnosis.
Management
There is no treatment for acephaly, as the condition is lethal. Management focuses on providing support and counseling to the affected family. Genetic counseling may be offered to discuss the risk of recurrence in future pregnancies.
Epidemiology
Acephaly is an extremely rare condition, with only a few documented cases in the medical literature. The incidence of acephaly is difficult to determine due to its rarity and the likelihood of underreporting.
Research
Ongoing research into neural tube defects aims to better understand the genetic and environmental factors that contribute to conditions like acephaly. Advances in prenatal screening and genetic testing may improve early detection and provide more information to affected families.
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Contributors: Prab R. Tumpati, MD