B V S Raman, K S V Prasad and B Hayagriva Rao
King George Hospital, India
Posters & Accepted Abstracts: J Neurol Neurophysiol
Introduction: Encephalomeningocele is a congenital malformation characterized by protrusion of meninges and/or
brain tissue due to a skull defect. It is one form of neural tube defects as the other two, anencephaly and spina bifida.
Despite the higher incidence of this congenital defect in this area, little is known about its etiology and pathogenesis.
Some evidence from previous studies suggest environmental factors as potential causes. So far, only aflatoxin has
been proposed to be a teratogenic agent for this anomaly. Indirect evidences from its closely related anomaly, spina
bifida, may suggest the role of folate deficiency in encephalomeningocele. Here, we report 10 cases of encephaloceles
in and review their epidemiological, clinical, imaging characteristics, as well as analyze the surgical results.
Material & Methods: The study was carried at Department of Neurosurgery, King George Hospital, Visakhapatnam
during year 2016 to 2018. Patients with encephalocele (occipital, Scincipital, parietal) admitted during year 2016
to 2018 were evaluated for their clinical features. Complete base line investigations were performed including
ultrasound, CT scan and MRI of brain. Other congenital anomalies were also noted in record. Written consent was
taken. Operative and postoperative records were maintained. Statistics in King George Hospital: 10 children with
encephalocele were selected during the years 2016-2018. Out of these 6 were male and 4 were female. Age range was
06 days to 2 years. Most common type of encephalocele was Frontal encephalocele. All patients underwent surgery.
Out of 10 only two patients died. Postoperative follow up showed uneventful results. Two of our cases required
postoperative VP shunt in addition to the repair of the sac. The immediate outcome was good in all except in 2
patients. Both presented with ruptured encephalocele and succumbed to meningitis. CSF leak and wound infection
observed in two cases improved on conservative
Discussion: Encephaloceles represents a congenital defect of the cranium which are common congenital problem in
the practice of neurosurgery worldwide. The contents of the sac vary from small dysplastic diverticulum to a large
amount of degenerative brain tissue with variable amount of CSF fluid. The bony defect can vary in size. Elective
surgery provides time for the patients to gain weight and strength and allows the surgeon to select the best technique.
Most large encephaloceles required urgent surgical treatment to avoid damage to sac. In all the occipital, parietal
and nasal encephaloceles there was dysplastic brain tissue which was removed safely. Postoperative hydrocephalus
should be managed. Through ventriculoperitoneal (VP) shunts as one or two-stage procedures.
Conclusion: Early surgical management of encephalocele is not only for cosmetic reasons but also to prevent
tethering, rupture, and future neurological deficits. Complications like hydrocephalus may need to be managed with
shunt surgery. Endoscopic procedures play an important role in fronto-naso-ethmoidal encephaloceles.
E-mail: ramanbhavana@gmail.com
