[The occipital encephaloceles: report of 16 cases].

Service de Neurochirurgie, CHU Fann de Dakar.
Le Mali médical 02/2007; 22(2):54-7.
Source: PubMed


The encephaloceles belong to dysraphic state abnormalities. Publications on this issue are rare and sparse in Africa. The aim of our study is to describe clinical patterns of occipital encephaloceles, and emphasize on surgery. We collect retrospectively a population of 16 patients. Cranial Ultrasound Echographia has been done for all of them. Only 3 patients got brain CT scan. Medium age was 2 months. The sex ratio was coted 1. The consanguinity was noted in 37% of the cases. The pedicular aspects were more frequent. With neuroimaging studies the diagnosis was reached everytime. It showed hydrocephalus on 3 patients. 15 patients have been operated. One dead before going to surgery. The outcome was good for 13 patients (81%). But 3 patients (18%) deaded, and among them, 2 deaded during post surgery period. A better clinical evaluation showed be done using MRI. The control of epidemiology of these conditions depend on the improvement of the quality of eating in particularly in women bearing child, and performing a genetic counseling.

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    ABSTRACT: Cephaloceles are congenital malformations characterized by externalization of the meninges and/or brain tissue through a congenital skull bone defect. In developed countries, this malformation is rare but in our developing countries, this pathology remains one of our concerns. To describe the epidemiological, clinical and therapeutic aspects of the cephaloceles. A retrospective study was conducted from 2007 to 2013 on all cases of cephalocele supported in the department of neurosurgery of the Yalgado Ouédraogo University Teaching Hospital of Ouagadougou. The malformations were supplemented by CT scan. All patients were operated. The surgical procedure in cephaloceles of the convexity consisted of a direct approach. Sincipital cephaloceles were operated by transcranial approach or combined approach associating transcranial and transnasal approaches. Fifty patients were gathered during the 7-year period. There were 18 boys and 32 girls. The ages ranged from 1 day to 11 years. The cephaloceles were located on the vault of the skull in 78%; the lesion was sincipital in 22%. The malformation was covered with normal skin in 92%; it was pediculated in 78%. CT scan allowed the classification of cases as meningo-encephaloceles in 31 cases (62%) and meningoceles in 18 cases (36%) and one pure encephalocele. The immediate postoperative course was uneventful in 42 cases (84%); 8 postoperative deaths were recorded. At medium and long term, 4 patients (8%) developed complications of psychomotor deficiency in 3 cases and hydrocephalus in 1 case. The main reasons for the poor prognosis were superinfection, hydrocephalus and/or other brain malformations. Cephaloceles remain relatively frequent in our practice. After surgery, mental failure and hydrocephalus can occur impairing the prognosis. The most suitable solution is a policy of prevention with folic acid treatment before and during pregnancy and following up adequate pregnancies. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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