Clinicopathological profile, management and outcome of patients with congenital encephalocele: a Nigerian tertiary centre experience.

purposeCongenital encephaloceles are rare neurosurgical conditions often associated with other intracranial anomalies. This study describes the clinicopathologic profile, management, and outcomes of patients with encephalocele in a Nigerian hospital.

methodsA 7-year retrospective review was conducted of patients managed for encephalocele in our institution. Data were collected in a structured proforma and analysed.

resultsThere were 7 females and 5 males, aged 1 to 60 days at presentation (median = 3 days); mean paternal and maternal ages were 33.42 ± 3.70 and 29.25 ± 3.91 years, with no reported maternal preconceptional folic acid use. The second-born child was most frequently affected (41.7%), and prenatal diagnosis was made in 3 patients; lesions were predominantly occipital (10) with 2 sincipital, and one case was giant (8.3%). Mean occipito-frontal circumference (OFC) was 34.96 ± 5.54 cm, decreasing with increasing lesion size (p = 0.672); 3 patients had concomitant hydrocephalus (commoner in sincipital lesions, 50% vs. 20%, p = 0.455), all had CSF diversion during repair. Mean age at surgery was 29.83 ± 22.62 days, mean operative time 129.17 ± 27.46 min, estimated blood loss 40.42 ± 16.71 mL, and blood volume transfused 49.17 ± 16.63 mL; repair was translesional in 11 and transcranial in 1 patient. Postoperative complications included surgical site infections, hydrocephalus, seizures (2 each), and 1 recurrence. At 30-day follow-up, there was no mortality and all parents were satisfied with cosmetic outcomes.

conclusionWhile this study demonstrated favorable short-term outcomes, it also highlights the need for public health initiatives promoting routine maternal preconceptional folic acid use.