An Integrated Approach to the Management of Meningoencephalocoeles

Area of Science:

• Neurosurgery
• Pediatric Surgery
• Craniofacial Surgery

Background:

• Meningoencephalocoeles are congenital cranial defects involving meningeal and brain tissue herniation.
• Prevalence is low in European populations (1/40,000 live births) but higher in South-East Asia.
• Surgical intervention by multidisciplinary craniofacial teams is the standard treatment.

Purpose of the Study:

• To review the management of congenital meningoencephalocoeles at a UK tertiary center.
• To analyze surgical approaches and outcomes.
• To emphasize the importance of a multidisciplinary team approach.

Main Methods:

• Retrospective case review of primary meningoencephalocoeles.
• Data collected from Oxford University Hospitals NHS Foundation Trust (1986-2012).
• Analysis of patient demographics, presentation, surgical techniques, and management strategies.

Main Results:

• 29 cases were reviewed (13 frontal, 9 occipital, 2 parietal, 5 basal).
• Median age at presentation was 11 months; common presentation was an external mass.
• 26 patients underwent surgery, 17 with multidisciplinary input; 20 transcranial approaches were used.

Conclusions:

• Multidisciplinary craniofacial units provide optimal management for meningoencephalocoeles.
• Integrated surgical approaches enhance patient safety and outcomes.
• This series underscores the complexity and successful management of these rare congenital defects.