Alojan Abdulrazaq Abdulmohsen, Alsaad Ibtihal Sadiq, Alghareeb Fatimah Yousef, Al-Issawi Wisam Mostafa, Ammar Ahmed Sabry
Department of Neurosurgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Asian J Neurosurg. 2019 Jul-Sep;14(3):1044-1047. doi: 10.4103/ajns.AJNS_60_19.
The authors present a patient who had a large occipital meningocele, which was transformed into an encephalocele after primary closure due to a large skull defect. Thus, the technical importance of classifying patients with occipital meningocele with a large skull defect and a tight dural obliteration is crucial, not to leave a wide dead space with a potential risk of cerebellar herniation. Encephalocele and meningocele are embryological anomalies, which result in intracranial structures herniation due to inborn skull defect. Acquired encephalocele may develop through the same defect with normal cerebellar tissues; since the prognosis of occipital encephalocele may worsen as the size of herniation increases, the patient underwent a modified dural obliteration technique (Cable Suturing Technique) to adjust the size of the dura and to strengthen it to prevent the risk of future herniation followed by cranioplasty and the cerebellar herniation regressed significantly after the procedure.
作者介绍了一名患有巨大枕部脑膜膨出的患者，该患者在初次缝合后因巨大颅骨缺损而转变为脑膨出。因此，对伴有巨大颅骨缺损和硬脑膜紧密闭塞的枕部脑膜膨出患者进行分类具有重要的技术意义，以免留下可能导致小脑疝的大死腔。脑膨出和脑膜膨出是胚胎学异常，由于先天性颅骨缺损导致颅内结构疝出。后天性脑膨出可通过相同的缺损与正常小脑组织一起发展；由于枕部脑膨出的预后可能随着疝出大小的增加而恶化，患者接受了改良的硬脑膜闭塞技术（缆线缝合技术）以调整硬脑膜的大小并加强其强度，以防止未来疝出的风险，随后进行颅骨成形术，术后小脑疝明显消退。
