Assignment 2- Noah Wall\'s case PDF

Preview

Summary

Assignment covering a paper holding the name of the patient (the famous Noah Walls case)...

Description

Guide lines to Case study report Abstract Introduction Social and historical story, refer to other cases (Disease involved) + prevalence Case presentation Diagnosis+ actual status 1-

the complaint that brought the patient to us (use the patient’s own words)

2- important information that we obtained from our history-taking. 3-

results of our clinical examination.

history and results of any examinations performed. The working diagnosis and management of the case are described Management and Outcome (Treatments)+ (Outcome) 1- plan for care, as well as the care which was actually provided, and the outcome. 2- indication of how and why treatment finished. Did we decide to terminate care, and if so, why? Did the patient withdraw from care or did we refer them to another practitioner? 3. Discussion + (Future perspective) + Your personal opinions (ethically & scientifically)

Synthesize the foregoing subsections and explain both correlations and apparent inconsistencies. If appropriate to the case, within one or two sentences describe the lessons to be learned. Reference

Abstract: In this case study, the case of a hydrocephalus diagnosed boy who conquered his disability to develop a partial fully developed brain is discussed. Noah Wall 8-year-old boy, grow 80% of his brain cells after a great loss in his brain cells has puzzled all neuroscientists till now. The disease is commonly spread around the world with no clear strategy to outcome the disease till now. The most common cause of the disease is the accumulation of CSF putting a great pressure on the brain cells and impairing their development. Noah wasn’t expected to live that long, however, scientist have attributed his survival to his great will and support from his parents. The child is pursuing a normal life which gives parents of abnormal pregnancies hope towards their babies chances of survival.

Introduction: Hydrocephalus is a medical condition where cerebrospinal fluid (CSF) accumulates due to impaired absorption or circulation with or with no pressure (source 1). This disorder is one of the most common types of brain diseases. For Latin America and Africa scores the highest congenital cases as 316 and 145 case per ten thousand children, respectively (source 2). However, United States and Canada tend to have 0.077 % lower cases than the eluted continents. In addition, The rate of hydrocephalus corelates with the income of countries. For instance, lower income countries scored higher rates of the brain disorder of interest. The patient of hydrocephalus requires the assistance of a caregiver either parents or nurses as a toddler to do life routine tasks and can’t perform them on his own even at older ages. As a result, Babies with disabilities forms a great load both financially, emotionally, and physically on the care giver. A study conducted by Michael et.al. (source) predicted that the number of cases will increase each year by 400,000 hydrocephalus new case. However, hydrocephalus can also occur in adults, this report only tackles the first type, the congenital type in newborns. Case Presentation Noah Wall, a boy who was diagnosed with severe hydrocephalus which destroyed 98% of his brain including the cerebral cortex. Noah’s medical case was under investigation since his mother first trimester. The fetal ultrasound depicted up normality in the fetus formation of neural tube and he was diagnosed then with spina bifida, A neural tube defect that impairs the formation of an intact spinal cord (source). Despite the doctor advice for Noah’s mother to get an abortion, they refused believing in the great will and capabilities of their yet unborn child. Another Concern for the doctors was that the Ultrasound scan revealed that the boy’s brain is missing a great part of the medulla oblongata which is responsible for breathing and thus the kid would be severally mentally and physically disabled (spurce). Abnormally, when Noah was born, he had a normal control of breathing and behavioral change overtime like normal child After the delivery by 3 months, Noah undertook an MRI scan to revel that he has only 2% of the normal brain (Figure 1). To every one’s surprise Noah developed 80% of his brain after 2 years which wasn’t expected. The doctors showed using an MRI scan test, that the boy could grow and compensate for the lost parts of his brain due to unknown reasons (Figurer 2). Management and outcomes: Noah 2% brain cells enabled him to lead a partial normal life that any kid aged 2 years old would have after developing the rest of his brain. Despite the fact that his lower limbs are paralyzed sue to the injury in the spinal cord and not a disfunction in the brain. Noah has no record of taking any medical intervention either to breath or to eat or any special care management. The only thing he was given was

the lover, support and encouragement of his parents which is believed to play an important and essential role in his unexplainable development. However, Doctors have no record of Noah developing the rest of his 20% lost brain cells back after the two years of birth.

Discussion: Neuroscientist have long believed that the conscious and awareness is fired by the aid of the cerebral cortex (Barrs and gage 2010). Also, it was believed that adolescence is the time when human brain stops developing and that after the age of three, children stop developing brain cells Largercrantz and Changeux, 2009; Rochat, 2003; Steiner, 1996. However, they elaborated, kids diagnosed with hydrocephalus only interact with the surrounding as a type of reflex and not conscious Pereira, 2016). However, the case of Noah wall has puzzled the world for eight years now. Doctors sought to figure how the only part of Noah’s brain which is the brain stem could trigger the development of the rest of the brain on purpose. Knowing that children suffering from hydrocephalus shouldn’t life more than a few years after birth due to their impaired body functions, Noah doesn’t suffer from the disease symptoms of the mental impairment part (Brwon et al. 1973). However, Pereira et al. (source) assumed that Noah’s brain stem initiated the development of the 80% brain cells as an act of free will and choice. It’s rather unconventional for parents to reject the decision of abortion knowing that their child would suffer in the outer world. Also, the financial and physical burden carried by both the care giver and the government to sustain a normal and applicable facilities for mentally retarded patients isn’t something to overlook. However, In Noah’s case, his parents believed that he could develop like any normal child which is apparent from the boy’s mother decision to keep her child. This case showed how little scientist know about the true human’s capabilities and hidden power of free will and choice. In my opinion, until we figure all the mysteries of Neuroscience, we can’t condemn the life of a child to death. As, Noah enjoys a semi perfect life now and he would thank his parents one day for their decision that they made as well as scientists. Another point concerning the ethical perspective, is that Noah is aware and conscious child and killing him as a fetus would have meant to kill a living non mentally retarded baby which is a criminal of humanity. In Future studies, the case of Noah should be studied intensively besides the genetic mutation and signaling triggering this late development. This would help greatly eliminating the suffering of hundreds of hydrocephalus babies. Also, the genetic mutation in Noah’s parents should be studied to figure the cause of them having such an ordinary child and their chances of having another baby with the same condition....