Ramdurg Shashank Ravindra, Sukanya M, Maitra Jayabrata
Department of Neurosurgery, MR Medical College, Kalaburagi, Karnataka, India.
J Pediatr Neurosci. 2015 Oct-Dec;10(4):317-20. doi: 10.4103/1817-1745.174462.
Encephalocele is the protrusion of the cranial contents beyond the normal confines of the skull through a defect in the calvarium and is far less common than spinal dysraphism. The exact worldwide frequency is not known.
To determine the epidemiological features, patterns of encephalocele, and its postsurgical results.
The study was carried from year July 2012 to June 2015. Patients with encephalocele were evaluated for epidemiological characteristics, clinical features, imaging characteristics, and surgical results.
20 encephaloceles patients were treated during the study period. Out of these 12 (60%) were male and 8 (40%) female. Age range was 1 day to 6 years. The most common type of encephalocele was occipital 12 (60%), occipito-cervical 4 (20%), parietal 2 (10%), fronto-nasal 1 (5%), and fronto-naso-ethmoidal 1 (5%). One patient had a double encephalocele (one atretic and other was occipital) with dermal sinus tract and limited dermal myeloschisis. Other associations: Chiari 3 malformation (2), meningomyeloceles (4), and syrinx (4). Three patients presented with rupture two of whom succumbed to meningitis and shock. Seventeen patients treated surgically did well with no immediate surgical mortality (except a case of Chiari 3 malformation who succumbed 6 months postsurgery to unrelated causes). Shunt was performed in 4 cases.
The most common type of encephalocele is occipital in our set up. Early surgical management of encephalocele is not only for cosmetic reasons but also to prevent tethering, rupture, and future neurological deficits.
脑膨出是指颅骨内容物通过颅骨缺损突出到颅骨正常边界之外,其发生率远低于脊柱裂。全球的确切发病率尚不清楚。
确定脑膨出的流行病学特征、类型及其术后结果。
本研究于2012年7月至2015年6月进行。对脑膨出患者进行流行病学特征、临床特征、影像学特征及手术结果评估。
研究期间共治疗20例脑膨出患者。其中男性12例(60%),女性8例(40%)。年龄范围为1天至6岁。最常见的脑膨出类型为枕部脑膨出12例(60%),枕颈脑膨出4例(20%),顶叶脑膨出2例(10%),额鼻脑膨出1例(5%),额鼻筛脑膨出1例(5%)。1例患者有双脑膨出(1个闭锁性脑膨出,另1个为枕部脑膨出),伴有皮窦道和局限性皮肤脊髓分裂症。其他合并症:Chiari 3畸形(2例)、脊髓脊膜膨出(4例)和脊髓空洞症(4例)。3例患者出现脑膨出破裂,其中2例死于脑膜炎和休克。17例接受手术治疗的患者恢复良好,无即刻手术死亡(除1例Chiari 3畸形患者术后6个月因无关原因死亡)。4例患者进行了分流术。
在我们的研究中,最常见的脑膨出类型为枕部脑膨出。脑膨出的早期手术治疗不仅是为了美观,也是为了预防牵拉、破裂及未来的神经功能缺损。