A giant occipital encephalocele

Abstract

Giant occipital encephaloceles are rare lesions. Because of their enormous size they pose a surgical challenge. Herein we report a four months old female baby who presented with progressively increasing swelling over the occipital region. This swelling was present since birth. Surgery was planned to reduce the size of the swelling as well as its contents. The redundant sac was excised and reduced sufficiently enough to accommodate the healthy looking brain tissue. In contrast to the previous case reports where the neonates had poor prognosis, this infant did well postoperatively.

Keywords: Neurological development; Occipital encephalocele; Microcephaly.

Figure 1: Clinical photograph showing giant occipital encephalocele.

Figure 2: CT scan brain showing large encephalocele sac with protrusion of the contents.

Figure 3: CT scan brain (bone window) showing large defect in the occipital bone with sclerosed margins.

Figure 4: Intra-operative photographs showing operative steps (B) small amount of the CSF was let out through a small opening in the sac, (C) note the reduction in the size of swelling, (D) sac was opened, (E) base of sac was defined, note the presence of large vessels near to the opening in the skull, (F and G) redundant brain tissue was excised while preserving the large vessels, (H and I) dura and skin were closed.