Large Vertex Encephaloceles: Management and Outcomes

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery
• Developmental Pediatrics

Background:

• Complex vertex and posterior encephaloceles present significant prognostic uncertainty and surgical risks.
• Access to specialized expertise influences treatment decisions for these pediatric cases.

Purpose of the Study:

• To review the surgical management and outcomes of pediatric patients with complex encephaloceles.
• To evaluate developmental functioning in children with cranial encephaloceles after referral for a second opinion.

Main Methods:

• Retrospective review of surgical assessment, planning, and techniques for cranial repairs.
• Analysis of surgical outcomes and developmental follow-up for adaptive functioning.

Main Results:

• Four of five pediatric patients underwent surgical reconstruction for encephalocele.
• No deaths occurred; complications included seizures and hydrocephalus requiring shunting in some patients.
• Developmental evaluations revealed delays in adaptive functioning for two patients.

Conclusions:

• Complex encephaloceles warrant evaluation at high-volume, tertiary pediatric craniofacial centers.
• Multidisciplinary team involvement is crucial for surgical decision-making.
• Further research on developmental outcomes for operated and unoperated patients is needed.