Occipital meningoceles in patients with the Dandy-Walker syndrome

Bindal, Ajay K.; Storrs, Bruce B.; McLone, David G.

doi:10.1097/00006123-199106000-00009

Cited by 22 publications

(32 citation statements)

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“…According to Bindal et al[ 20], 28 cases of occipital cephalocele associated with the Dandy-Walker syndrome included meningocele, encephalocele, or encephalocystomeningocele and 11 of the 28 cases had pure occipital meningocele. Overall 16% of cases of Dandy-Walker syndrome were associated with occipital meningocele in this series.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Large Occipitocervical Cephaloceles: A 10-Year Experience

Kotıl

Kılınç

Bılge³

2008

Pediatr Neurosurg

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Background/Aims: Cephaloceles are common malformations of the central nervous system. However, the great majority of clinical experiences in large occipitocervical cephaloceles have not been reported previously. The purpose of this report is to investigate the pathogenetic factors involved in the development of cranial dysraphism and to analyze the clinical and pathological factors that influence the outcome in patients. Methods: Three hundred and twenty infants with craniospinal dysraphism and 12 with large occipitocervical cephaloceles were admitted to our institution in a 10-year interval between 1995 and 2005. Infants with cephaloceles, including newborns and 5 within the first year of life, were all operated by two authors in our institution, and they were analyzed retrospectively. Results: The sex predilection was limited to occipitocervical cephaloceles, where 8 of the 12 cases were females. Hydrocephalus was present in 25% of the patients at the time of diagnosis. Clinical presentation was most often consistent with hydrocephalus, focal neurological findings being a less prominent feature. Associated congenital anomalies were present in 50% of the children. Contemporary neuroimaging techniques including computed tomography and magnetic resonance imaging facilitated the diagnosis. Patients were initially managed by posterior fossa or cervical region exploration, followed by sac excision. Three cases died in the early postoperative period, and the surgical mortality in this series was 25%. They were the ones with the largest encephaloceles and microcephaly. The mean follow-up time was 3.4 years. The overall mortality rate for the whole series was 33.3% (4/12). The size of the cephaloceles and the presence or absence of neural tissue in the sac largely determines the outcome for patients with occipitocervical cephaloceles. Conclusion: Infants with lesions greater than 50 mm in diameter, containing a significant amount of neural tissue, have an extremely poor prognosis, especially if associated with microcephaly.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Large Occipitocervical Cephaloceles: A 10-Year Experience

Kotıl

Kılınç

Bılge³

2008

Pediatr Neurosurg

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“…Shunting of both the lateral ventricle and the posterior fossa cyst is the current treatment in children with DWM and associated aqueductal stenosis [5, 21, 22]. In 92%, control of hydrocephalus, reduction of the intracranial pressure and of the size of the posterior fossa cyst could be achieved.…”

Section: Discussionmentioning

confidence: 99%

“…(1) The complication rate of simultaneous shunting seems to be higher: Gerszten and Albright [6] observed twice as many complications in ventriculoperitoneal plus cystoperitoneal shunts than in monocompartmental shunts, with the shunt malfunction more likely to be caused by the cystoperitoneal component [5]. (2) High failure rates of ETV in children have been reported by some authors.…”

Section: Discussionmentioning

confidence: 99%

“…In cases of additional aqueductal obstruction, simultaneous drainage of both compartments is required to avoid transtentorial pressure gradient and herniation. Unfortunately, combined shunt placement carries a higher rate of complications than monocompartmental shunting [5, 6]. Recently, endoscopic third ventriculostomy (ETV) combined with a stent from the third ventricle through the aqueduct into the cyst has been introduced as a surgical alternative in patients with DWM and aqueductal obstruction [7].…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Transtentorial Ventriculocystostomy and Cystoventriculoperitoneal Shunt in a Neonate with Dandy-Walker Malformation and Associated Aqueductal Obstruction

et al. 2005

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Objective: Shunting of the lateral ventricle and the posterior fossa cyst is the advocated surgical therapy for children with Dandy-Walker malformation (DWM) and associated aqueductal obstruction. The high rate of complications of combined shunting stimulated the authors to search for an alternative surgical solution. Clinical Presentation/Intervention: After transtentorial endoscopic ventriculocystostomy, a cystoventricular catheter, connected to a peritoneal shunt, was placed in a neonate with DWM and associated aqueductal obstruction. Immediately prior to ventriculocystostomy, the presence of a blocked third ventricular outflow was reconfirmed by contrast medium injection. Neuronavigation was required to define the surgical path from the lateral ventricle through the tentorium and the overlying small rim of brain parenchyma into the posterior fossa cyst. The postoperative clinical course was uneventful with radiologically proven reduction of the size of the ventricular system and the cyst. Conclusion: Cystoventriculoperitoneal shunt placement after transtentorial endoscopic ventriculostomy is a surgical alternative in very young children with DWM and associated aqueductal obstruction.

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“…It has been reported that if only a meningocele is present in the setting of Dandy-Walker syndrome, it can resolve after shunt placement without surgery, with subsequent ossification [8]. However, in this case the protruding intracranial contents were removed at least 1 year earlier in a surgical procedure for which the description was not available and there was no evidence of bone formation within the residual occipital bone defect.…”

Section: Discussionmentioning

confidence: 89%

Imaging Assessment of Re-Exploratory Repair of an Occipital Bone Defect-Associated Tectocerebellar Dysraphism via Hybrid Cranioplasty

Ginat

Reid²,

Frim³

2016

Pediatr Neurosurg

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Occipital meningoceles in patients with the Dandy-Walker syndrome

Cited by 22 publications

References 0 publications

Diagnosis and Management of Large Occipitocervical Cephaloceles: A 10-Year Experience

Diagnosis and Management of Large Occipitocervical Cephaloceles: A 10-Year Experience

Endoscopic Transtentorial Ventriculocystostomy and Cystoventriculoperitoneal Shunt in a Neonate with Dandy-Walker Malformation and Associated Aqueductal Obstruction

Imaging Assessment of Re-Exploratory Repair of an Occipital Bone Defect-Associated Tectocerebellar Dysraphism via Hybrid Cranioplasty

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