Dorcas Padget (1906–1973) and her contributions to spinal dysraphism and Chiari II malformations
Following Dandy’s death, Padget continued as a research assistant at the University of Maryland School of Medicine, Division of Neurological Surgery. Although never graduating from Vassar, she continued to publish and research her laboratory efforts on neuroembryology, especially on neural tube development. In addition, she was one of the first to visualize the complex development of embryological vasculature, especially intracranially .
Padget coined the term neuroschisis and developed a neuroschisis theory that was used to explain the spectrum of spinal dysraphism. According to her neuroschisis theory, abnormal folding of an irregularly widened neural tube (from disorganized growth) was the foundation of many congenital malformations of the spinal cord. For example, she posited that a neuroschisis bleb is formed by the escape of neurocele fluid into the surrounding mesoderm, which becomes walled off by a mesodermal membrane. Spina bifida anomalies subsequently develop from the different fates of the bleb such that a healed bleb would result in spina bifida occulta. Rupturing of the bleb with eversion of the margins of the neural cleft margins was opined to lead to crainum bifidum . Such abnormal folding, which is more prominent in the midbrain and hindbrain regions, would also lead to narrowing of the neurocele with potential collapse and resultant microcephaly. In addition, the sylvian aqueduct could be stenosed resulting in hydrocephalus and overcrowding of the small posterior cranial fossa thus leading to herniation and Chiari II malformation [4, 5].
Dorcas Padget continued her research until she passed away at John Hopkins on September 15, 1973 . Her contributions to our understanding of neural tube development cannot be overstated.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 2.Travnicek J, Callas A (2016) Dorcas Hager Paget: medical illustrator for Walter E. Dandy. Congress Quarterly 2016:22–24Google Scholar
- 4.Padget DH (1972) Development of so-called dysraphism; with embryologic evidence of clinical Arnold-Chiari and Dandy-Walker malformations. Johns Hopkins Med J 130(3):127–165Google Scholar