Introduction: Cephalocele is a herniation of brain tissue and/or its membranes due to a dehiscence of the skull. It can be presented as a meningocele, encephalocele, or meningoencephalocele. Objective: To share a series of cases of operated cephaloceles. Materials and Methods: This was a retrospective observational study conducted at the Regional Hospital Center of Kaolack from February 1, 2022, to January 31, 2024. We analyzed clinical, radiological, therapeutic, and evolutionary data of all patients operated on for cephalocele. Results: We recorded 11 patients operated on for cephalocele over 23 months. The average age was 2 months, with extremes ranging from 6 days to 7 months. The sex ratio was 0.4. A history of consanguinity among parents was found in 7 out of 11 cases. Three mothers had no prenatal follow-up. Occipital location was predominant, and the average diameter of the neck was 7 cm. All patients underwent a brain CT scan, revealing an encephalocele in seven cases and a meningocele in four cases. Additionally, six out of seven patients had associated hydrocephalus. All patients were operated on, and a favorable outcome was obtained in seven patients. Four cases of reoperation were noted, among which we noted two cases of death. Conclusion: This malformation remains relevant, with its incidence linked to the socio-economic level of a country. The risk of morbidity and mortality is very high, emphasizing the need for good prenatal follow-up.
References
[1]
Gueye, M., Badiane, S.B., Sakho, Y. and Massoni, F. (1989) Céphalocèles au Senegal. Analyse d’une série de 65cas. Inter-Fac Afrique, 8, 13-17.
[2]
Lo, B.W.Y., Kulkarni, A.V., Rutka, J.T., Jea, A., Drake, J.M., Lamberti-Pasculli, M., et al. (2008) Clinical Predictors of Developmental Outcome in Patients with Cephaloceles. JournalofNeurosurgery:Pediatrics, 2, 254-257. https://doi.org/10.3171/ped.2008.2.10.254
[3]
Oucheng, N., Lauwers, F., Gollogly, J., Draper, L., Joly, B. and Roux, F. (2010) Frontoethmoidal Meningoencephalocele: Appraisal of 200 Operated Cases. JournalofNeurosurgery:Pediatrics, 6, 541-549. https://doi.org/10.3171/2010.9.peds1043
[4]
Sanoussi, S., Chaibou, M., Bawa, M., Kelani, A. and Rabiou, M. (2010) Encéphalocèle occipitale: Aspects épidémiologiques, cliniques et thérapeutiques: À propos de 161 cas opérés en 9 ans à l’hôpital national de niamey. AfricanJournalofNeurologicalSciences, 28, 26-31. https://doi.org/10.4314/ajns.v28i1.55129
[5]
Warf, B.C., Stagno, V. and Mugamba, J. (2011) Encephalocele in Uganda: Ethnic Distinctions in Lesion Location, Endoscopic Management of Hydrocephalus, and Survival in 110 Consecutive Children. JournalofNeurosurgery:Pediatrics, 7, 88-93. https://doi.org/10.3171/2010.9.peds10326
[6]
Kabré, A., Zabsonre, D.S., Sanou, A. and Bako, Y. (2015) The Cephaloceles: A Clinical, Epidemiological and Therapeutic Study of 50 Cases. Neurochirurgie, 61, 250-254. https://doi.org/10.1016/j.neuchi.2015.03.011
[7]
Diarra, M.S., Cisse, M.E.H., Dama, M., Diallo, O. and Kanikomo, D. (2021) Management of Encephaloceles at the Mother & Child Hospital “Le Luxembourg” of Bamako. Health Sciences and Diseases, 22, 92-96.
[8]
Thiam, A.B., Faye, M., Kessely, Y.C., Ndoye, N., Mbaye, M., Thioub, M., Thiam, L., Sy, C., Ba, M.C. and Badiane, S.B. (2014) Cephaloceles à Dakar: Étude de 30 cas au CHUN FANN. Sciences de la santé, 2, 14-18.
[9]
Sogoba, Y., Kanikomo, D., Sogoba, B., Kourouma, D., Coulibaly, O., Amadou, I., et al. (2018) Surgical Repair of Encephaloceles in Gabriel Touré Hospital: Review of 17 Cases. OpenJournalofModernNeurosurgery, 8, 375-382. https://doi.org/10.4236/ojmn.2018.84033
[10]
Simpson, D.A., David, D.J. and White, J. (1984) Cephaloceles: Treatment, Outcome, and Antenatal Diagnosis. Neurosurgery, 15, 14-21. https://doi.org/10.1227/00006123-198407000-00005
[11]
Padmanabhan, R. (2006) Etiology, Pathogenesis and Prevention of Neural Tube Defects. CongenitalAnomalies, 46, 55-67. https://doi.org/10.1111/j.1741-4520.2006.00104.x
[12]
Candito, M. and Van Obberghen Folates, E. (2001) Vitamine B12, homocystéine et anomalies du tube neural. Annales de Biologie Clinique (Paris), 59, 111-112.
[13]
Fine, E.L., Horal, M., Chang, T.I., Fortin, G. and Loeken, M.R. (1999) Evidence That Elevated Glucose Causes Altered Gene Expression, Apoptosis, and Neural Tube Defects in a Mouse Model of Diabetic Pregnancy. Diabetes, 48, 2454-2462. https://doi.org/10.2337/diabetes.48.12.2454
[14]
Ray, J.G., Wyatt, P.R., Vermeulen, M.J., Meier, C. and Cole, D.E.C. (2005) Greater Maternal Weight and the Ongoing Risk of Neural Tube Defects after Folic Acid Flour Fortification. Obstetrics&Gynecology, 105, 261-265. https://doi.org/10.1097/01.aog.0000151988.84346.3e
[15]
Aguiar, M.J.B., Campos, Â.S., Aguiar, R.A.L.P., Lana, A.M.A., Magalhães, R.L. and Babeto, L.T. (2003) Defeitos de fechamento do tubo neural e fatores associados em recém-nascidos vivos e natimortos. JornaldePediatria, 79, 129-134. https://doi.org/10.1590/s0021-75572003000200007
[16]
Cuillier, F. (2001) Diagnostic anténatal d’une exencéphalie à 10 SA, confirmé à 13 SA. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 30, 706-707.
[17]
AlRefai, A., Drake, J., Kulkarni, A.V., Connor, K.L., Shannon, P., Toi, A., et al. (2018) Fetal Myelomeningocele Surgery: Only Treating the Tip of the Iceberg. PrenatalDiagnosis, 39, 10-15. https://doi.org/10.1002/pd.5390
[18]
Owen, T.J., Halliday, J.L. and Stone, C.A. (2000) Neural Tube Defects in Victoria, Australia: Potential Contributing Factors and Public Health Implications. AustralianandNewZealandJournalofPublicHealth, 24, 584-589. https://doi.org/10.1111/j.1467-842x.2000.tb00521.x
[19]
Gupta, R., Dhirawani, R., Pathak, S. and Lalwani, G. (2014) Frontoethmoidal Encephalocele: Case Report and Review on Management. AnnalsofMaxillofacialSurgery, 4, 195-197. https://doi.org/10.4103/2231-0746.147140
[20]
Hervey-Jumper, S.L., Cohen-Gadol, A.A. and Maher, C.O. (2011) Neurosurgical Management of Congenital Malformations of the Brain. NeuroimagingClinicsofNorthAmerica, 21, 705-717. https://doi.org/10.1016/j.nic.2011.05.008
