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Cephaloceles - experience with 42 patients

T Czech1, A Reinprecht, C Matula

  • 1Department of Neurosurgery, Nordstadtkrankenhaus, Hannover, Federal Republic of Germany.

Acta Neurochirurgica
|January 1, 1995
PubMed
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Cephaloceles, or brain hernias, were surgically treated in 42 patients. Occipital and anterior fontanelle cephaloceles showed good outcomes, while basal lesions presented with cerebrospinal fluid (CSF)-rhinorrhea.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Medical Imaging

Background:

  • Cephaloceles are congenital herniations of brain tissue through skull defects.
  • Understanding the varied locations and associated malformations is crucial for effective management.
  • Historical treatment data provides valuable insights into surgical outcomes.

Purpose of the Study:

  • To review surgical outcomes for various types of cephaloceles.
  • To correlate lesion location with associated malformations and clinical presentation.
  • To evaluate the impact of advanced imaging on diagnosis and management.

Main Methods:

  • Retrospective analysis of 42 patients with 44 cephaloceles treated between 1966 and 1993.
  • Classification of lesions by location: occipital, parietal, anterior fontanelle, sincipital, and basal.

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  • Review of clinical signs, associated malformations, surgical procedures, and post-operative outcomes.

    • Main Results:

    • Occipital (18) and basal (12) lesions were most common.
    • Associated malformations were more frequent with cranial vault lesions.
    • Cerebrospinal fluid (CSF)-rhinorrhea was the primary sign in basal cephaloceles.
    • Surgical excision was performed in all but one case; 7 patients required shunting.
    • Complications included persistent CSF-leaks (5) and infections (2).

    Conclusions:

    • Good outcomes were observed for anterior fontanelle and occipital meningoceles.
    • Basal cephalocele management requires careful attention to CSF-rhinorrhea.
    • Advanced imaging like CT and MRI significantly improves diagnosis of cephalocele characteristics and associated anomalies.