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Occipital encephalocoeles in 57 Nigerian children: a retrospective analysis
T Shokunbi1, A Adeloye, A Olumide
1Department of Anatomy, University of Ibadan, Nigeria.
Insights
Occipital encephalocoeles in Nigerian infants present significant surgical challenges. High operative mortality and developmental delays highlight the poor prognosis for this condition.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Clinical Neurology
Background:
- Occipital encephalocoeles are congenital malformations presenting significant challenges in pediatric neurosurgery.
- This study examines a series of cases from Nigeria, providing insights into the clinical presentation and outcomes.
Purpose of the Study:
- To retrospectively analyze the clinical characteristics, surgical management, and outcomes of occipital encephalocoeles.
- To identify factors influencing operative mortality and long-term neurodevelopmental prognosis.
Main Methods:
- Retrospective review of 58 patients with occipital encephalocoeles treated between 1973 and 1987.
- Data collected included patient demographics, lesion size, surgical intervention, operative mortality, and postoperative complications.
Main Results:
- A female preponderance (2:1) was observed, with 91% of patients treated in infancy.
- Lesion size frequently exceeded 5 cm, and operative mortality was 6%, primarily in neonates with brain tissue in the hernia sac.
- Postoperative hydrocephalus and developmental delay were observed in a significant proportion of patients.
Conclusions:
- Occipital encephalocoeles in this cohort had a high incidence of large lesions and a considerable operative mortality, particularly in neonates.
- Postoperative hydrocephalus and developmental delays are significant concerns, suggesting a poor long-term prognosis for many affected infants.
Abstract:
Fifty-eight patients with occipital encephalocoeles were retrospectively examined. These comprised about one-half of the cases seen and evaluated for treatment at the University College Hospital, Ibadan, Nigeria, between January 1973 and December 1987. There was a female-to-male preponderance of 2:1. Of the patients 91% were treated during infancy. Only one patient was precluded from surgery because his large ulcerated lesion was associated with severe microcephaly and neonatal sepsis, to which he succumbed. About four-fifths of the lesions exceeded 5 cm in diameter. The operative mortality was 6%, all deaths occurring in patients who were neonates at the time of surgery and whose hernia sacs contained brain substance. Clinically apparent hydrocephalus was more frequently encountered postoperatively, than preoperatively. Developmental delay was apparent in 5 of the 13 patients in whom developmental milestones were assessed during follow-up. For most patients, the follow-up period was short, possibly a reflection of the poor prognosis of the disease.