Treatment of anterior encephaloceles over 24 years in Kosova

Abstract

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.