Exencephaly is a type of
cephalic disorder
Cephalic disorders () are congenital conditions that stem from damage to, or abnormal development of, the budding nervous system.
Cephalic disorders are not necessarily caused by a single factor, but may be influenced by hereditary or genetic c ...
wherein the brain is located outside of the skull. This condition is usually found in embryos as an early stage of
anencephaly
Anencephaly is the absence of a major portion of the brain, skull, and scalp that occurs during embryonic development. It is a cephalic disorder that results from a neural tube defect that occurs when the rostral (head) end of the neural tube fa ...
. As an exencephalic pregnancy progresses, the neural tissue gradually degenerates.
The prognosis for infants born with exencephaly is extremely poor. It is rare to find an infant born with exencephaly, as most cases that are not early stages of anencephaly are usually
stillborn
Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can result in the feeling of guilt or grief in the mother. The ter ...
. Those infants who are born with the condition usually die within hours or minutes. Caused by the failure of cranial
neuropore to properly fuse, between the 3rd and 4th week post conception. The
calvarium doesn't develop/fuse properly, therefore the brain extrudes from the cranium.
Pathophysiology
Until recently, the medical literature did not indicate a connection among many
genetic disorder
A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorde ...
s, both
genetic syndromes
A syndrome is a set of medical signs and symptoms which are correlated with each other and often associated with a particular disease or disorder. The word derives from the Greek σύνδρομον, meaning "concurrence". When a syndrome is paired ...
and
genetic diseases
A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders ...
, that are now being found to be related. As a result of new genetic research, some of these are, in fact, highly related in their
root cause Root cause may refer to:
* "Root Cause" (''Person of Interest''), a TV show episode
* Root cause analysis
In science and engineering, root cause analysis (RCA) is a method of problem solving used for identifying the root causes of faults or pro ...
despite the widely varying set of medical
symptoms
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showi ...
that are clinically visible in the
disorders. Exencephaly is one disease that has recently been identified as part of an
emerging class of diseases called
cilopathies. The underlying cause may be a dysfunctional molecular mechanism in the primary
cilia
The cilium, plural cilia (), is a membrane-bound organelle found on most types of eukaryotic cell, and certain microorganisms known as ciliates. Cilia are absent in bacteria and archaea. The cilium has the shape of a slender threadlike projecti ...
structures of the
cell,
organelle
In cell biology, an organelle is a specialized subunit, usually within a cell, that has a specific function. The name ''organelle'' comes from the idea that these structures are parts of cells, as organs are to the body, hence ''organelle,'' t ...
s which are present in many cell types throughout the
human
Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, ...
body. The cilia defects adversely affect "numerous critical developmental signaling pathways" essential to cellular development and thus offer a plausible hypothesis for the often
multi-symptom nature of a large set of syndromes and diseases. Known ciliopathies include
primary ciliary dyskinesia
Primary ciliary dyskinesia (PCD) is a rare, autosomal recessive genetic ciliopathy, that causes defects in the action of cilia lining the upper and lower respiratory tract, sinuses, Eustachian tube, middle ear, Fallopian tube, and flagella of sp ...
,
Bardet–Biedl syndrome
Bardet–Biedl syndrome (BBS) is a ciliopathic human genetic disorder that produces many effects and affects many body systems. It is characterized by rod/cone dystrophy, polydactyly, central obesity, hypogonadism, and kidney dysfunction in s ...
,
polycystic kidney and
liver disease
Liver disease, or hepatic disease, is any of many diseases of the liver. If long-lasting it is termed chronic liver disease. Although the diseases differ in detail, liver diseases often have features in common.
Signs and symptoms
Some of the s ...
,
nephronophthisis
Nephronophthisis is a genetic disorder of the kidneys which affects children. It is classified as a medullary cystic kidney disease. The disorder is inherited in an autosomal recessive fashion and, although rare, is the most common genetic cause o ...
,
Alström syndrome
Alström syndrome (AS), also called Alström–Hallgren syndrome, is a very rare autosomal recessive genetic disorder characterised by childhood obesity and multiple organ dysfunction. Symptoms include early-onset type 2 diabetes, cone-rod dy ...
,
Meckel–Gruber syndrome
Meckel-Gruber syndrome is a rare, lethal ciliopathic genetic disorder, characterized by renal cystic dysplasia, central nervous system malformations (occipital encephalocele), polydactyly (postaxial), hepatic developmental defects, and pulmonar ...
and some forms of
retinal degeneration.
See also
*
Anencephaly
Anencephaly is the absence of a major portion of the brain, skull, and scalp that occurs during embryonic development. It is a cephalic disorder that results from a neural tube defect that occurs when the rostral (head) end of the neural tube fa ...
Notes
{{Reflist
External links
NINDS Overview
Congenital disorders of nervous system