Spinal lesion level in spina bifida: a source of neural and cognitive heterogeneity.

Object: The aim of this study was to evaluate whether the level of a spinal lesion is associated with variations in anomalous brain development and neurobehavioral outcomes in children suffering from the meningomyelocele form of spina bifida and hydrocephalus (SBM-H).

Methods: Two hundred sixty-eight children with SBM-H were divided into upper (T-12 and above; 82 patients) and lower (L-1 and below; 186 patients) lesion-level groups. Magnetic resonance images were qualitatively coded by radiologists and quantitatively segmented for cerebrum and cerebellum volumes.

Family ties. Grandparents raising grandchildren.

When grandparents are raising their children's children, family dynamics change considerably. Nurses can be instrumental in assessing these clients in their health care needs, and providing education and support.