Surgical closure and reconstruction of a large occipital encephalocele without parenchymal excision

Bozinov, Oliver; Tirakotai, Wuttipong; Sure, Ulrich; Bertalanffy, Helmut

doi:10.1007/s00381-004-1020-5

Cited by 41 publications

(54 citation statements)

References 12 publications

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“…Cephalocele is defined as a protrusion of cranial contents beyond the normal confines of the skull [1,2,3,4,5,6]. The cephalocele is called as occipitocervical if it occupies a defect in the occipital bone and in the posterior arch of one or more cervical vertebrae [5].…”

Section: Introductionmentioning

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: Introductionmentioning

confidence: 99%

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

Kotıl

Kılınç

Bılge³

2008

Pediatr Neurosurg

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“…In addition, for herniated occipital and cerebellar parenchyma, incision is made in the tentorium to create an infratenterial space for the herniated tissue to retract. Currently nasal endoscopy is a valuable procedure in diagnosis and treatment of memnigoencephalocels, it was introduced in early 1980s and emerged as the procedure of choice for meningoencephaloceles [10]. There are some factors that may influence the prognosis of patients with meningoencephalocele, The size of the herniated sac and the amount of brain tissue it contains determine the prognosis of these patients.…”

Section: Discussionmentioning

confidence: 99%

Occipital Meningoencephalocele case report and review of current literature

Alwahab¹,

Kharsa²,

Nugud³

et al. 2017

Chin Neurosurg Jl

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Background: Meningoencephalocele is a rare congenital anomaly that is characterized by herniation of brain tissue through a defect in skull. Generally, it could be divided by anatomical location of defect to occipital and frontoethmoidal. The exact etiology of this condition is unknown but many theories have been postulated. The condition is usually seen at birth but can be identified prenatally. Case presentation: A newborn was brought to the hospital after a normal non-complicated vaginal delivery done by the ambulance personnel. The newborn had a bulging mass on the posterior aspect of the head. Therefore, he was admitted and neurosurgical consultation was done for further evaluation. Currently the patient is following up in well baby clinic as well as the neurosurgery clinic for normal development and milestones acquisition. Conclusions: This case presents the opportunity for junior healthcare professionals to learn about a group of congenital neurological disorder in the content of a rare case presentation.

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“…The presence of microcephaly with a large occipital encephalocele containing significant brain tissue is also a predictor of poor neurological outcome. [5][6][7] Despite the unusual location, the presence of large blood vessels, the great sac and skull defect, and the venous drainage to the sagittal sinus, this case had no surgical complications.…”

Section: Discussionmentioning

confidence: 99%

Antenatally diagnosed posterior Meningoencephalocele: a case report

Mhapankar

Vadukkut

Patil

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Congenital encephalocele is a neural tube defect which is caused by an embryonic development abnormality. It is characterized by a sac-like protrusion of the brain, meninges and other intracranial structures through the skull. 75% of encephalocoeles are occipital. Pre-natal screening is very essential for timely recognition of the condition. At the same time, proper intake of folic acid in the first few weeks of pregnancy may reduce the occurrence of this form of NTD. The prognosis is variable depending on the presence of associated anomalies and presence of microcephaly (carries a much poorer prognosis). A favorable surgical outcome generally follows an accurate strategy taking into account individual features of the lesion. A Caesarian delivery may be considered to allow for less traumatic birth for the fetal head. Here we present a case of a foetus with posterior meningoencephalocoele diagnosed antenatally at 32 weeks of pregnancy. Patient was delivered by elective Cesearian section. The encephalocoele was resected and the defect was closed primarily. The baby was well on the regular follow-up at the neurosurgery outpatient department.

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Surgical closure and reconstruction of a large occipital encephalocele without parenchymal excision

Abstract: In the long-term follow-up after 13 years, the child has preserved visual function.

Cited by 41 publications

References 12 publications

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

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

Occipital Meningoencephalocele case report and review of current literature

Antenatally diagnosed posterior Meningoencephalocele: a case report

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