Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2014.049
Autopsy and Case Reports
Article / Clinical Case Report

Huge interparietal posterior fontanel meningohydroencephalocele

Jorge Félix Companioni Rosildo; Manuel Filipe Dias Dos Santos; Rita de Cassia de Santa Barbara

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Abstract

Congenital encephalocele is a neural tube defect characterized by a sac-like protrusion of the brain, meninges, and other intracranial structures through the skull, which is caused by an embryonic development abnormality. The most common location is at the occipital bone, and its incidence varies according to different world regions. We report a case of an 1-month and 7-day-old male child with a huge interparietal-posterior fontanel meningohydroencephalocele, a rare occurrence. Physical examination and volumetric computed tomography were diagnostic. The encephalocele was surgically resected. Intradural and extradural approaches were performed; the bone defect was not primarily closed. Two days after surgery, the patient developed hydrocephaly requiring ventriculoperitoneal shunting. The surgical treatment of the meningohydroencephalocele of the interparietal-posterior fontanel may be accompanied by technical challenges and followed by complications due to the presence of large blood vessels under the overlying skin. In these cases, huge sacs herniate through large bone defects including meninges, brain, and blood vessels. The latter present communication with the superior sagittal sinus and ventricular system. A favorable surgical outcome generally follows an accurate strategy taking into account individual features of the lesion.
 

Keywords

Encephalocele, Brain, Meninges, Physical Examination, Hydrocephalus

References

Volpe JJ. Neurology of the newborn. 3rd ed. Philadelphia: W.B. Saunders; 1995. p. 3-42: Neural tube formation and prosencephalic development.

Chávez-Corral DV, López-Serna N, Levario-Carrillo M, Sanín LH. Defectos del tubo neural y de labio y paladar hendido: un estudio morfológico. Int J Morphol. 2013;31(4):1301-8. [https://doi.org/10.4067/S0717-95022013000400025]. [Spanish.]

Barreto E, Barbosa J, Telles C. [Anatomical classification of anterior encephaloceles]. Arq Neuropsiquiatr. 1993;51(1):107-11. [https://doi.org/10.1590/S0004-282X1993000100017]. [PMID:8215917]

Vila Morales D. Clasificación de las alteraciones cefalogénicas desde una visión integradora craneomaxilofacial. Rev Cubana Estomatol. 2013;50(1):2-27. Spanish.

Rivera Oliva L, Sarmiento Portal Y, Hernández León O, Portal Miranda ME, Martínez Vergara Y. Encefalomenigocele atrésico parietal. Rev Cubana Pediatr. 2011;83(3):296-301. Spanish.

Blustajn J, Netchine I, Frédy D, Bakouche P, Piekarski JD, Meder JF. Dysgenesis of the internal carotid artery associated with transsphenoidal encephalocele: a neural crest syndrome? AJNR Am J Neuroradiol. 1999;20(6):1154-7. [PMID:10445462].

Mylanus EA, Marres HA, Vlietman J, et al. Transalar sphenoidal encephalocele and respiratory distress in a neonate: a case report. Pediatrics. 1999;103(1):E12. [https://doi.org/10.1542/peds.103.1.e12]. [PMID:9917492]

Berlucchi M, Pedruzzi B, Sessa M, Nicolai P. Diagnostic and therapeutic sinonasal endoscopy in pediatric patients. In: Iancu C, editor. Advances in endoscopic surgery. Rijeka: InTech; 2011 [cited 2014 Oct 31]. Available from: http://www.intechopen.com/books/advances-in-endoscopicsurgery/diagnostic-and-therapeutic-sinonasal-endoscopy-in-pediatric-patients. http://dx.doi.org/10.5772/2188610.5772/21886.

Sánchez R, Gómez E, Martin M, Burgueño M. Obstrucción nasal neonatal: encefalocele basal. Rev Esp Cir Oral Maxilofac. 2012;34(3):133-5. [https://doi.org/10.1016/j.maxilo.2011.08.004].

Almirón JF, Arévalo MJA, Bellazzi MV, Fernández NG, Arévalo JC. Encefalocele frontonasal: reporte de un caso clínico. Rev. posgrado VIa. Cátedra Med [Internet]. 2009 [cited 2014 Oct 31];(195):13-6. Available from: http://med.unne.edu.ar/revista/revista195/3_195.pdf

Diego MC, Gabriel H, Omaira N, Edelmary N, Lenier N, Odalis V. Encefalocele occipital y reparación quirúrgica: presentación de un caso clínicoRev Mex Neurocienc. 2012 Nov-Dec 13(6):319-23. Spanish.

Samaniego Fernández CM, Cancho Candela R, Centeno Malfaz F. Enfermedades graves con diagnóstico prenatal. Cuad Bioet. 2012;23(77):195-214. Spanish. [PMID:22548667]


 


Publication date:
01/12/2016

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