Encephalocele: A Case Series From Abuja, North Central Nigeria

Abstract

An encephalocele is a congenital tube defect in which there is an extension of intracranial structures outside the normal confines of the skull. Its presentation at birth provokes a lot of anxiety amongst parents, guardians and care providers with regards to compatibility with life, surgical treatments and effects on developmental milestones and higher mental functions. This report is on our initial experience in the first six months following surgical treatment of four consecutive cases presenting in infancy. The aim of this case series is to report our initial experience of the management of encephaloceles using four consecutive cases that presented in infancy. A review of four infants who presented to our neurosurgery service was conducted including patterns of presentation, neuroimaging findings, scope of surgical intervention and neurological outcome at the six-month review. The results are presented in short case reports and summarized in a table. Two five-month-old females, one six-month-old female and one two-month-old female infants presented to our neurosurgery clinic with progressively increasing encephaloceles at different locations. Brain MRI revealed meningo-encephalocele in all, but with associated hydrocephalus in two cases only. They all had excision and repair of encephalocele under the same general anaesthesia while only two had a ventriculoperitoneal (VP) shunt. Developmental milestones were on course at 6 months follow-up following discharge. Although the presentation of encephaloceles can be frightening to parents and care providers, careful clinical and radiological evaluation is a recipe for sound surgical planning and improved outcome.

Will improved neuroradiology facilities debunk the reported rarity of intracranial aneurysms in Sub-Saharan Africa?

“…Experiences in other parts of Nigeria and Africa seem to support this view. A study in Abuja, Nigeria, [34] reported that across a 4-year period, 57 patients presented with aSAH but only 25 were confirmed to harbor 27 aneurysms while 47% could not afford the cost of confirmation investigations, thus giving an annual A recent scoping review of aneurysmal SAH in Africa revealed the scanty publications on this important subject that dominates neurosurgical literature. [30] Interestingly, most of the publications emanated from North African countries.…”

“…Autopsy studies have provided information on the incidence of IAs although there may be concerns about the accuracy [29] Ibadan Nigeria 1988-1999 17 1.6 Ohaegbulam [24] Enugu, Nigeria 1974-1977 5 1.7 Ugwuanyi et al [34] Abuja Nigeria 2016-2020 27 6.7 Tokpa et al [33] Abidjan Corte Ivoire 2012-2018 128 18.3 ioub et al [32] Dakar Senegal 2013-2016 129 36.8 Ogenga' o et al [22] Nairobi Kenya 1998-2007 56 6.2 Nabaweesi-Batuka et al [19] Nairobi, Kenya 2010-2014 121 30 El Khamlichi et al [5] Rabat Morocco 1983-1999 200 11.7 Khan et al [12] Quarter 2007-2016 323 32.3 Ramnarayan et al [26] Kozhikode, India 1998-2003 182 36.4 Law et al [16] Hong Kong 2002-2006 135 33.75 van Munster et al [35] Kuopulo Finland 1986-2005 1786 94 van Munster et al [35] Utrecht, Netherlands 1986-2005 1788 94 Korja et al [14] Helsinki, Finland 1995-2009 1993 142.4…”

“…Sub-Saharan Africa has consistently recorded low intracranial aneurysm (IAN) frequencies prompting some reporters to argue that IAN are rare. [24,29,34] e debate is whether the observed (angiography, computed tomography [CT], and magnetic resonance imaging [MRI]), inpatient and operating theater database of the hospital.…”

“…Sub-Saharan Africa has consistently recorded low intracranial aneurysm (IAN) frequencies prompting some reporters to argue that IAN are rare. [ 24 , 29 , 34 ] The debate is whether the observed differences are apparent or real. Some neurosurgeons have suggested that the burden of cerebral aneurysms in Africa might be underestimated due to underreporting.…”

Meningomyelosel ve Ensefalosel Onarımı İçin Anestezi Yönetimi: 58 Olgunun Gözden Geçirilmesi

“…Bu kusurlar beyni, omurgayı veya omuriliği etkileyebilir ve genellikle hamileliğin ilk ayında ortaya çıkar. Kusurlu embriyogenez dışında, viral enfeksiyon, hipertermi, radyasyon, hipervitaminoz, hipoksi ve erken gebelikte salisilat tedavisi gibi çeşitli faktörler oluşumuna katkıda bulunabilir (2,3). Kranial disrafizm, kraniyal nöral tüpün kapanmaması durumudur ve anensefali ve ensefalosel içerir.…”