Incidence of Secondary Hydrocephalus after Excision of Huge Encephaloceles in Neonates: Case Study

Refaee, Ehab Ahmed El; Refaat, Mohamed; Reda, Mohamed

doi:10.1055/s-0036-1597548

Cited by 6 publications

(11 citation statements)

References 9 publications

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“…La prevalencia del encefalocele varía de 0.08 a 0.4 por cada 1 000 nacidos vivos [4][5][6].El meningohidroencefalocele es un defecto congénito del tubo neural cuya característica es una herniación o protrusión de las meninges, encéfalo y ventrículos a través de un defecto del cráneo; este saco herniario esta generalmente cubierto por cuero cabelludo [1][2][3][4][5]. La herniación ocurre entre las 8 a 12 semanas de gestación en el sitio de una disrupción mesenquimatosa local, se origina por la separación anormal entre el ectodermo de superficie y el neural en los sitios de cierre [4]. Aproximadamente el 75% de los encefaloceles están ubicados en la región occipital, seguido de la frontoetmoidal (13% -15%) y parietal (10% -12%) [6].…”

Section: Discussionunclassified

“…La ecografía continúa siendo de gran valor en el diagnóstico prenatal, permite evidenciar la presencia o ausencia de tejido cerebral en el defecto; además a través del estudio exhaustivo, permite evaluar de forma integral el desarrollo fetal y la presencia de otras alteraciones del neuro-eje [4][5][6][7]. Clínicamente, las encefaloceles gigantes son evidentes debido a su morfología [8].…”

Section: Discussionunclassified

“…La etiología exacta de los encefaloceles no ha sido identifica aún; sin embargo, se sospecha de antecedentes genéticos, factores ambientales y deficiencias nutricionales maternas. El folato prenatal no tiene ningún papel protector en la prevención de la aparición del encefalocele [4,5].…”

Section: Introductionunclassified

“…El pronóstico de los recién nacidos con encefalocele depende de varios factores incluido; el sitio, el tamaño y el contenido del encefalocele, además de la presencia de microcefalia y otras anomalías asociadas. Un número significativo de estos pacientes carecen de desarrollo normal y pueden presentarse clínicamente con déficit neurológicos [4,5].…”

Section: Introductionunclassified

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Caso Clínico: Meningohidroencefalocele Gigante

Villacres¹,

Cudco²,

Morocho³

2021

Rev Med HJCA

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BACKGROUND: Encephaloceles are a rare congenital anomaly, affecting 1 in 5 000 live births.A meningohydroencephalocele is the herniation of the meninges, ventricles, and part of the brain through a congenital defect in the skull. The prognosis of newborns depends on several factors. The young age and the associated congenital anomalies in these patients contribute to the diagnostic and treatment challenge. CASE REPORT: Male newborn, born at 37 weeks of gestation, by emergency C-section due to latent labor, presenting a large mass over the parieto-occipital region, with lobed, irregular edges, partially covered by the scalp, and in other areas a purplish red tone. The newborn was no very reactive, had decreased tone, absent crying. EVOLUTION: After specialist’s evaluation, due to the significant defect in the cranial shell and the structural brain abnormalities, the patient was not a candidate for surgical treatment. The newborn was discharged with a reduced life expectancy, to receive care at home. CONCLUSION: giant meningohydroencephalocele is a rare neural tube defect. The management of encephaloceles can be complicated and must be individualized, and will depend on the anatomical structures involved. Although in this case the prognosis was bad, multidisciplinary work is always necessary for proper management.

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Section: Discussionunclassified

Section: Introductionunclassified

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Caso Clínico: Meningohidroencefalocele Gigante

Villacres¹,

Cudco²,

Morocho³

2021

Rev Med HJCA

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“…16 Other authors have also suggested that the larger the EC sac size, the greater will be the likelihood of hydrocephalus development. 17,18 Predicting the likelihood of hydrocephalus development and the associated risk factors in patients with EC can help physicians tailor their treatment strategies to ensure lower mortality and morbidity rates in affected patients. In this study, we reviewed our series of patients with EC and analyzed the risk factors/predictors that correlate with the occurrence of hydrocephalus.…”

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confidence: 99%

Hydrocephalus in patients with encephalocele: introduction of a scoring system for estimating the likelihood of hydrocephalus based on an 11-year experience from a tertiary center

Kankam

Nejat

Tavallaii

et al. 2023

Journal of Neurosurgery: Pediatrics

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OBJECTIVE The goal of this study was to investigate and identify the predictors associated with the incidence of hydrocephalus requiring shunt insertion in patients with encephalocele (EC), and to develop a scoring system to estimate the probability of hydrocephalus occurrence over time in these patients. METHODS A retrospective analysis was undertaken on data from patients treated for EC at a tertiary medical center between 2010 and 2021. Data including patient age at presentation, sex, sac location, sac size, contents, presence of ventriculomegaly/hydrocephalus, CSF leakage, and other associated intracranial/extracranial anomalies were among the variables evaluated for their predictive value. In addition, logistic regression analyses were performed to identify the independent predictors. A predictive scoring system was developed based on regression coefficients. RESULTS A total of 102 cases of EC were identified. The patient group consisted of 52 boys and 50 girls. Seventy-one patients (69.6%) had posterior ECs. Forty-three (42.2%) of the ECs contained neural tissue. Thirty-three patients presented with ventriculomegaly (32.4%), 30 of whom (90.9%) underwent ventriculoperitoneal shunt placement for hydrocephalus. Multivariate analysis revealed that the presence of other associated anomalies (OR 2.8, 95% CI 1.1–7.4, p = 0.027), larger EC sac size (OR 1.3, 95% CI 1.01–1.6, p = 0.042), and infections (OR 6.8, 95% CI 1.3–34.8, p = 0.034) were associated with ventriculomegaly. The logistic regression model consisted of 5 variables including the patients’ history of meningitis, their sex, sac location, sac size, and presence of other other associated anomalies; analysis resulted in the maximum accuracy of 86% for the prediction of hydrocephalus occurrence. CONCLUSIONS According to the findings, the presence of other associated anomalies, a larger sac, and infections are significant independent predictors of hydrocephalus. By considering these 3 predictors as well as sac location and the patient’s sex, it will be possible to predict hydrocephalus occurrence in patients with EC with significant accuracy.

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