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ORIGINAL ARTICLE
Year : 2018  |  Volume : 35  |  Issue : 2  |  Page : 207-213

Microsurgical management results of occipital encephalocele


1 Department of Neurological Surgery, Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt
2 Department of Pathology, Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt
3 Department of Radiology, Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt

Correspondence Address:
Dr. Ashraf El Badry
Department of Neurosurgery, Faculty of Medicine, Mansoura University Hospital, Mansoura
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bmfj.bmfj_120_17

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Background Encephalocele is a central nervous system birth anomaly with a herniation of the brain and the covering meninges through a bony skull defect to the exterior. Objective The aim of this research was to describe the prognostic factors and current possible hypotheses explaining associated anomalies observed in a series of 17 patients with encephalocele and show the effectiveness of setting up a microsurgical technique in the treatment of these cases. Materials and methods Seventeen patients who were identified with occipital encephaloceles and referred to our Neurosurgery Clinic at the Mansoura University Hospital, Mansoura Insurance Hospital, between October 2004 and July 2013 were enrolled in this study. Patients’ sex, age at the time of the procedure, features of the lesion including site, size, associated cerebrospinal fluid leak, radiological evaluation and intraoperative findings (sac contents), and intracranial and extra cranial-associated anomalies were determined in the study. Results In our study, 17 patients (12 female and five male) were included. Their ages varied between newborn and 1 month. The encephalocele sac was situated in the occipital region in 15 (88.2%) patients and in the occipitocervical region in two (11.8%) patients. We used a microsurgical technique on all patients. Five (29.4%) of the 17 patients died: three in the postoperative early period (0–7 days) and two in the late postoperative period (2 weeks to 3 months). The mortality rate in our study was 29.4%. Conclusion The evidence in our series showed the importance of some factors that can alter the survival of patients with occipital encephalocele such as the sac size, the neural tissue existence in the content, hydrocephalus, infections, and other associated malformations. In this study, we report improvements in the surgical results by introducing the microsurgical technique as an alternative to traditional management despite the high morbidity and mortality linked to this congenital anomaly.


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