Hydrocephalus and occipital encephaloceles: presentation of a series and review of the literature

Protzenko, Tatiana; Gomes, Saint Clair; Bellas, Antonio Rosa; Salomão, J. Francisco

doi:10.1007/s00381-021-05312-7

Cited by 15 publications

(26 citation statements)

References 28 publications

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“…ECs are congenital lesions of the midline sagittal axis of the cranium, and may be classified as a neural tube defect. 14,15 Although the pathogenesis is unknown, they have a multifactorial pattern, similar to other neural tube defects. 22 It is suggested that this malformation may be due to mesodermal insufficiency caused by adhesion between neuroectoderm and surface ectoderm between 3 and 4 weeks of gestation, with subsequent epithelialization of the lesion.…”

Section: Discussionmentioning

confidence: 99%

“…22 It is suggested that this malformation may be due to mesodermal insufficiency caused by adhesion between neuroectoderm and surface ectoderm between 3 and 4 weeks of gestation, with subsequent epithelialization of the lesion. 15,23,24 In general, ECs have a favorable prognosis with a mortality rate below 10%. 4,6,13,20 However, the presence of some predictors has been shown to worsen the prognosis 9,14 and affect the neurodevelopmental outcome.…”

Section: Discussionmentioning

confidence: 99%

“…24 Also, other studies observed the strong association between DWS and hydrocephalus. 15,20 DWS is often associated with posterior ECs 31 and is estimated to occur in approximately 11%-16% of ECs. 5,31 According to Kotil et al, 31 the presence of DWS compensates for the raised intracranial pressure during fetal life.…”

Section: Correlation Of Other Associated Anomalies With Neurodevelopm...mentioning

confidence: 99%

“…2,6,11,12 Some of these associated congenital anomalies are considered to be risk factors or predictors that may lead to failure to obtain typical developmental milestones and result in neurodevelopmental problems in affected children. 1,3,6 Although NDD has been descriptively reported among many studies of ECs, 9,[14][15][16][17][18][19] very few studies have objectively evaluated outcomes and the correlation between predictors and NDD outcomes. 2,6,12,20 In this study, a series of patients with EC has been reviewed for identification of NDD via clinical evaluation and according to the Centers for Disease Control and Prevention (CDC) criteria for child development.…”

mentioning

confidence: 99%

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The neurodevelopmental outcomes of children with encephalocele: a series of 102 patients

Kankam

Tavallaii

Mohammadi

et al. 2023

Journal of Neurosurgery: Pediatrics

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OBJECTIVE The overall prognosis of encephalocele (EC) is not well described. However, the presence of some risk factors may result in neurodevelopmental delay (NDD) and negatively affect the prognosis of affected patients. The goal of this study was to evaluate neurodevelopmental outcome, as well as the impact of a number of factors on the outcome in patients with ECs. METHODS This was an observational, retrospective study including 102 children with EC who were followed at the pediatric neurosurgery department of a tertiary medical center between the years 2010 and 2021. The authors evaluated NDD status according to the Centers for Disease Control and Prevention classification via clinical evaluation and parent interviews in the outpatient setting. RESULTS There were 52 boys and 50 girls. The median age at the time of surgery was 4 months (range 1 day–7.5 years). Seventy-one patients (69.6%) had posterior ECs, whereas 31 (30.4%) had anterior ECs. Forty-three (42.2%) of the ECs contained neural tissue. Of the 102 patients, 33 (32.4%) had ventriculomegaly. In terms of NDD, 14 (14.9%) had mild/moderate delay, whereas 17 patients (18.1%) had severe NDD. On univariate analysis, posterior location, size of sac, presence of neural tissue, ventriculomegaly, symptomatic hydrocephalus, and postoperative infection were correlated with NDD. On a multivariate logistic regression model, only neural tissue presence had a statistically significant association with NDD (OR 7.04, 95% CI 1.33–37.2, p = 0.022). Although not statistically significant, children with ventriculomegaly were 2.6 times as likely to have NDD (95% CI 0.59–11.19, p = 0.362). CONCLUSIONS This is a single-center study with a large sample size in which the neurodevelopmental status of patients with EC was assessed, and the authors tried to find the risk factors of NDD in these patients. The results showed that the presence of neural tissue within the EC sac was the only risk factor that had independent statistically significant association with NDD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Correlation Of Other Associated Anomalies With Neurodevelopm...mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

The neurodevelopmental outcomes of children with encephalocele: a series of 102 patients

Kankam

Tavallaii

Mohammadi

et al. 2023

Journal of Neurosurgery: Pediatrics

View full text Add to dashboard Cite

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“…Of course, small defects can be repaired by direct suture 4 or large defects with small pedicles can also be repaired by direct suture. 5 However, there is a lack of uniform repair methods for large deletions. From the literature, there are 4 categories of current treatment methods:…”

Section: Discussionmentioning

confidence: 99%

Closure of Giant Dorsal Lumbosacral Myelomeningocele in Children Using Double Expanded Flaps: A Case Report and Literature Review

Chen,

Shen,

Han

et al. 2023

Journal of Craniofacial Surgery

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Introduction: Myelomeningocele (MMC) is the most common neural tube defect that can occur due to neural tube’s failure to fuse properly during embryonic life. To prevent this, expanded flaps can be used for closure of large MMCs. Presentation of Case: A 4-year and 6-month girl was diagnosed with multiple congenital anomalies including hydrocephalus, dorsal lumbosacral MMC, and congenital tethered cord syndrome. Preoperative evaluation showed no lower limb movements and the size of the sacrococcygeal region was about 10 cm × 8 cm × 15 cm mass, prominent thoracic kyphosis, and no obvious urogenital or limb anomalies. The large dorsal lumbosacral MMC was treated with a double expanded flap to reconstruct, the soft tissue defect following the neurosurgical reconstruction. Discussion: The expanded flap was deemed as viable as all wounds were healed without any complications, such as dehiscence, leakage of cerebrospinal fluid, or infection. The technique described in the case report offers an effective method of closure. Conclusion: This flap can be an effective method for reconstruction of large dorsal lumbosacral MMC defects that might improve outcomes and minimize complications. It also ensures minimal wound tension and breakdown.

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Occipital encephalocele associated with Dandy-Walker malformation: a case-based review

et al. 2022

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Hydrocephalus and occipital encephaloceles: presentation of a series and review of the literature

Cited by 15 publications

References 28 publications

The neurodevelopmental outcomes of children with encephalocele: a series of 102 patients

The neurodevelopmental outcomes of children with encephalocele: a series of 102 patients

Closure of Giant Dorsal Lumbosacral Myelomeningocele in Children Using Double Expanded Flaps: A Case Report and Literature Review

Occipital encephalocele associated with Dandy-Walker malformation: a case-based review

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