Anesthetic management of a newborn with occipital meningocele for magnetic resonance imaging

Neeta, S; Upadya, Madusudhan; Pachala, Sri Sruthi

doi:10.4103/0259-1162.156349

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…It can be associated with other congenital anomalies such as intestinal malrotation, renal anomalies, cardiac malformations and tracheoesophageal fistula. [1]…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic Management of a Giant Cervico-Occipital Meningocele with Cleft Palate

Jain

Dalal²,

Bamba

2020

AAN

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Meningocele is herniation of meninges and CSF through the skull and vertebral defect. The major anaesthetic challenges encountered in management of cervico-occipital meningocele include difficulty in securing airway, proper positioning of the neonate without pressure on the meningocoele sac, maintaining prone position and prevention of electrolyte disturbances and hypothermia. Associated congenital anomalies also can cause anaesthesia and procedure related complications. We report a case of 25 day old neonate with giant cervico occipital meningocele with cleft palate posted for excision and repair.

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“…It can be associated with other congenital anomalies such as intestinal malrotation, renal anomalies, cardiac malformations and tracheoesophageal fistula. [1]…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic Management of a Giant Cervico-Occipital Meningocele with Cleft Palate

Jain

Dalal²,

Bamba

2020

AAN

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Anaesthetic managements of 16 days’ neonate with large occipital meningeoencephalocele in a resource-limited setting, Ethiopia: a clinical case report and review of literature

Ibrahim,

Ayen,

Belayneh

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction: Meningoencephalocele is a rare congenital neural tube defect that results in herniation of brain tissue, necessitating surgical treatment. However, anesthetic management of meningoencephalocele is challenging because of the giant occipital mass in airway management, particularly for anesthetists working in resource-limited settings. Therefore, this case report aimed to share the challenges encountered during the perioperative anesthesia management of a giant occipital meningoencephalocele in Ethiopia. Case presentation: A 16-day-old female neonate was referred from a health center in Ethiopia for surgical excision and repair of a giant occipital meningoencephalocele (GOM). The main challenges were hemodynamic instability and airway management due to the giant mass on neck movement and inability to achieve the optimal position for intubation. Methods: A single clinical case report discussed challenges encountered during perioperative anesthesia management of GOM in a resource-limited setting in Ethiopia, and this work has been reported in line with the SCARE 2023 criteria. Conclusion: Anesthesia management in neonates with GOM is challenging for anesthetists in resource-limited settings because of the scarcity of different airway equipment and large masses. Another concern was to avoid pressure on the GOM due to rupture, which may result in hemodynamic instability and hypothermia. Therefore, attention should be paid to proper handling of the airway, hypothermia, and fluid loss. Generally, managing an occipital meningoencephalocele poses challenges for anesthetists, particularly in terms of securing the airway. Despite these challenges, we managed with locally available resources.

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Airway Management of Giant Occipital Meningoencephalocele Removal

Senapathi

Suandrianno

Sidemen

et al. 2021

Bali Journal of Anesthesiology

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Cephalocele refers to defects in the skull and dura with extensions from intracranial to extracranial structures. Cephalocele is divided into four types which are meningoencephalocele, meningocele, atretic encephalocele, and gliocele. Encephalocele is a head's contents herniation through a defect in the skull. Meningocele is a herniation sac that contains cerebrospinal fluid and nerve elements. Meningoencephalocele is a prominent herniation of the meningeal part, nerve elements, and brain tissue in a sac that protrudes through a defect in the skull. In Southeast Asia, the incidence of meningoencephalocele is estimated to occur in 1 in 5000 live births. The occipital bone is the most common location of cephalocele. The neurological outcome of malformations that occur depends on the size of the sac formed, the nerve tissue involved, hydrocephalus, related infections, and other pathological conditions involved. Perioperative preparation must be well made by an anesthesiologist based on airway management, fluid balance, and hypothermia prevention. The main challenge of anesthesia in the management of the occipital meningoencephalocele is securing the airway. Pediatric patients have low functional reserve volume, and failure of tracheal intubation can cause hypoxemia, bradycardia, and even heart attacks. Improper positioning and limited neck extension can complicate endotracheal intubation.

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Anesthetic management of a newborn with occipital meningocele for magnetic resonance imaging

Cited by 3 publications

References 6 publications

Anaesthetic Management of a Giant Cervico-Occipital Meningocele with Cleft Palate

Anaesthetic Management of a Giant Cervico-Occipital Meningocele with Cleft Palate

Anaesthetic managements of 16 days’ neonate with large occipital meningeoencephalocele in a resource-limited setting, Ethiopia: a clinical case report and review of literature

Airway Management of Giant Occipital Meningoencephalocele Removal

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