Ugwuanyi Ugo, Ayogu Obinna, Onobun Daniel E, Salawu Morayo, Mordi Chizimenu O
Neurosurgery, National Hospital Abuja, Abuja, NGA.
Neurosurgery, Wellington Neurosurgery Centre, Abuja, NGA.
Cureus. 2022 Mar 17;14(3):e23249. doi: 10.7759/cureus.23249. eCollection 2022 Mar.
An encephalocele is a congenital tube defect in which there is an extension of intracranial structures outside the normal confines of the skull. Its presentation at birth provokes a lot of anxiety amongst parents, guardians and care providers with regards to compatibility with life, surgical treatments and effects on developmental milestones and higher mental functions. This report is on our initial experience in the first six months following surgical treatment of four consecutive cases presenting in infancy. The aim of this case series is to report our initial experience of the management of encephaloceles using four consecutive cases that presented in infancy. A review of four infants who presented to our neurosurgery service was conducted including patterns of presentation, neuroimaging findings, scope of surgical intervention and neurological outcome at the six-month review. The results are presented in short case reports and summarized in a table. Two five-month-old females, one six-month-old female and one two-month-old female infants presented to our neurosurgery clinic with progressively increasing encephaloceles at different locations. Brain MRI revealed meningo-encephalocele in all, but with associated hydrocephalus in two cases only. They all had excision and repair of encephalocele under the same general anaesthesia while only two had a ventriculoperitoneal (VP) shunt. Developmental milestones were on course at 6 months follow-up following discharge. Although the presentation of encephaloceles can be frightening to parents and care providers, careful clinical and radiological evaluation is a recipe for sound surgical planning and improved outcome.
脑膨出是一种先天性神经管缺陷，即颅内结构延伸至颅骨正常范围之外。其出生时的表现会引起父母、监护人及护理人员对患儿生存能力、手术治疗以及对发育里程碑和高级心理功能影响的诸多担忧。本报告介绍了我们对4例婴儿期连续病例进行手术治疗后头6个月的初步经验。本病例系列的目的是报告我们对4例婴儿期脑膨出病例进行治疗的初步经验。我们对4例到神经外科就诊的婴儿进行了回顾，内容包括临床表现形式、神经影像学检查结果、手术干预范围以及6个月复查时的神经学转归。结果以简短病例报告形式呈现，并汇总在一张表格中。2名5个月大的女婴、1名6个月大的女婴和1名2个月大的女婴到我们神经外科门诊就诊，她们不同部位的脑膨出均呈进行性增大。脑部磁共振成像显示，所有患儿均为脑膜脑膨出，但仅2例伴有脑积水。她们均在同一次全身麻醉下接受了脑膨出切除及修复手术，只有2例进行了脑室腹腔分流术。出院后6个月随访时，发育里程碑进展正常。尽管脑膨出的表现可能会令父母和护理人员感到恐惧，但仔细的临床和影像学评估是进行合理手术规划并改善预后的秘诀。
