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Treatment of anterior encephaloceles over 24 years in Kosova
Arsim Morina1, Fatos Kelmendi, Qamile Morina
1University Clinical Center of Kosova, Clinic of Neurosurgery, Rruga e spitalit p.n., 10 000 Prishtina, Kosova.
Insights
This study reviewed 36 anterior encephalocele cases, finding that early surgical removal, especially in one stage, can achieve excellent results. Delayed surgery in very young children is avoided due to complication risks.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Case Studies
Background:
- Reports 36 anterior encephalocele cases treated over 24 years at the Clinic of Neurosurgery, University Clinical Center of Kosova.
- Analyzes a cohort of 36 pediatric patients (1 day to 10 years) with diverse encephalocele types, including nasofrontal, nasoethmoidal, and nasoorbital.
- Identifies associated conditions such as hypertelorism (12 patients) and hydrocephalus (11 patients, 8 progressive).
Purpose of the Study:
- To review and analyze the outcomes of treating anterior encephaloceles.
- To evaluate the effectiveness of surgical interventions for pediatric anterior encephaloceles.
- To identify factors influencing treatment outcomes and complications.
Main Methods:
- Retrospective study of 36 pediatric patients diagnosed with anterior encephalocele between 1986 and 2009.
- Inclusion criteria encompassed all treated cases within the specified period.
- Data collected included patient demographics, encephalocele type and size, associated anomalies, and surgical outcomes.
Main Results:
- The most common encephalocele types were nasofrontal (17), nasoethmoidal (12), and nasoorbital (7).
- One patient (1/36) died post-surgery due to meningitis; cosmetic results were rated excellent/good in 28/36 patients.
- No patients were lost to follow-up, and histologic examination revealed variable tissue types.
Conclusions:
- Early surgical removal of meningoencephalocele is crucial for normal growth.
- Simultaneous correction of hypertelorism and management of hydrocephalus are recommended for optimal results.
- One-stage surgical approaches can achieve excellent outcomes, with surgery deferred in very young children to mitigate risks of blood loss and hypothermia.
Introduction:
In the present study we report 36 cases of anterior encephaloceles treated at Clinic of Neurosurgery in the University Clinical Center of Kosova over a 24 year period.
Materials And Methods:
All 36 children were included in this retrospective study (1986 through 2009). Their ages ranged from 1 day to 10 years (mean 13 months); 20 were boys and 16 were girls. The commonest type of anomaly seen was nasofrontal 17 patients, 12 nasoethmoidal, and 7 nasoorbital. The size of the lesion varied from 2.5 cm to 28 cm. Hypertelorism occurred in 12 patients. Hydrocephalus was present in 11 patients and in 8 of them was progressive.
Results:
1 patient died on 10th postoperative day due to fulminant meningitis. Cosmetic results were judged from parents as excellent in 16 patients, good in 12 patients, average in 6 patients and poor in 2 patients. None of patients were lost to follow-up.
Discussion:
Histologic examination of the herniated tissue can vary between normal brain to fibrous atrophic nonviable tissue. No familial cases have been reported in the literature, we also have similar experience. In our study we have found that the prevalence is higher among patients coming from rural parts of our country with pore living conditions, malnutrition and so on. We have avoided surgery in very young children until body weight is around 5-6 kg because of complication from blood lose and hypothermia.
Conclusion:
The aim of treatment is early removal of the meningoencephalocele to allow normal growth forces to be re-established. In patients with hypertelorism, correction surgery is done in the same session. Ifhydrocephalus is not treated before corrective surgery for encephalocele, the risk of postoperative CSF is very high. With one stage surgery excellent results can be achieved.
