scholarly journals Giant occipital encephalocele: a case report, surgical and anesthetic challenge and review of literature

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Soha Zahid ◽  
Ahtesham Khizar

Abstract Background An encephalocele is a congenital neural tube defect characterized by herniation of cranial contents through a defect in the cranium and is caused by failure of the closure of the cranial part of the developing neural tube. An encephalocele is termed as “giant encephalocele” when the size of encephalocele is larger than the size of the head. They depend on size of the sac, percentage of neural tissue content, hydrocephalus, infection, and other associated pathologies for a favorable neurological outcome. Case presentation We report a case of a four-month-old boy with a giant occipital encephalocele measuring 21 × 15 × 19 cm in size, which was a surgical and anesthetic challenge for us. Intubation was achieved in lateral position. Part of occipital and cerebellar parenchyma was present in the sac and bony defect was approximately 2.5 cm in occipital bone in midline. We performed surgical excision and repair with a good overall outcome. Conclusion Perioperative management of a giant occipital encephalocele is a challenge for both anesthesiologists and neurosurgeons. Managing such a case demands a search for other congenital abnormalities, expertise in handling airway, and proper intraoperative care. Careful planning and perioperative management are essential for a successful outcome.

2021 ◽  
Author(s):  
Soha Zahid ◽  
Ahtesham Khizar

Abstract Background: An encephalocele is a congenital neural tube defect characterized by herniation of cranial contents through a defect in the cranium and is caused by failure of the closure of the cranial part of the developing neural tube. An encephalocele is termed as “giant encephalocele” when the size of encephalocele is larger than the size of the head. They depend on size of the sac, percentage of neural tissue content, hydrocephalus, infection, and other associated pathologies for a favorable neurological outcome.Case Presentation: We report a case of a four month old boy with a Giant Occipital Encephalocele about 21 x 15 x 19 cm in size, who was a surgical and anesthetic challenge for us. Intubation was achieved in lateral position. Part of occipital and cerebellar parenchyma was present in the sac and bony defect was approximately 2.5 cm in occipital bone in midline. We did Surgical Excision and Repair with a good overall outcome.Conclusion: Perioperative management of a Giant Occipital Encephalocele is a challenge for both anesthesiologist and neurosurgeon. Managing such a case demands search for other congenital abnormalities, expertise in handling airway and proper intraoperative care. Careful planning and perioperative management are essential for a successful outcome.


2021 ◽  
Vol 10 (1) ◽  
pp. 42-45
Author(s):  
Prakash Kafle ◽  
Mohan Raj Sharma ◽  
Sushil Krishna Shilpakar ◽  
Gopal Sedain ◽  
Amit Pradhanang ◽  
...  

Background: There are limited studies pertaining to management of encephalocele in Nepal. So the present study seems justifiable to bridge the gap in the literature on encephalocele from Nepal on its clinical profile and early outcome. This study aims to characterize the clinical profile, management and outcome of largest series of encephalocele at tertiary care center in Nepal. Materials and Methods: A retrospective analysis of encephalocele, managed surgically at two tertiary care centers between 2015 and 2020, was performed. Results: Total of 25 cases was surgically managed in the present study. The median age of study population was 2.5 months. There were 11 male and 14 female with male to female ratio of 1:1.26. Occipital encephalocele was the most common variant. Lump in the head (n=11) was the commonest clinical presentation followed by hyperteliorism (n=10). One patient presented with cleft lip and one had CSF discharge in a case of occipital encephalocele. Bony defect was the common radiological findings. Excision and repair was the most common mode of surgery leading to good outcome. Mortality rate was 4% with morbidity of 20%. Conclusion: Early surgical excision and tight dural closure with repair of bony defect is the standard treatment with relatively good outcome.


2011 ◽  
Vol 02 (02) ◽  
pp. 159-161 ◽  
Author(s):  
Zeynep Baysal Yildirim ◽  
Emel Avci ◽  
Fuat Torun ◽  
Mustafa Cengiz ◽  
Ali Çigdem ◽  
...  

ABSTRACT Introduction: Encephalocele, midline defect of cranial bone fusion, occurs most frequently in the occipital region. Airway management in pediatric patients with craniofacial disorders poses many challenges to the anesthesiologist. The purpose of this study is to describe the airway problems encountered for such cases, and describe how these problems were managed. Materials and Methods: We reviewed the charts of occipital encephalocele newborn that were treated by surgical correction in Harran University Hospital during 2006–2008. The collected data were categorized into preoperative, intraoperative, and postoperative data. Results: The mean age of the patients was 5.17 days. Of these 17 patients, eight patients (47.1%) had hydrocephaly, one patient (5.8%) with Dandy Walker syndrome. Micrognathia, macroglossia, restriction in neck movements were recorded as the reasons in six cases each. No major anesthetic complication was found. Conclusions: We reported perioperative management in 17 occipital encephalocele infant. Comprehensive care during peroperative period is essential for successful outcome.


Author(s):  
Rohit Bhoil ◽  
Vijay Thakur ◽  
Yashwant Singh Verma ◽  
Sabina Bhoil ◽  
Ashwani Tomar ◽  
...  

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li-cheng Song ◽  
Qian Xu ◽  
Hui Li ◽  
Zhi-jun Li ◽  
Ya Li ◽  
...  

Abstract Background Osteochondroma is the most common benign bone neoplasm and is sometimes referred to as osteocartilaginous exostosis. The symptoms caused by osteochondroma are rare, especially the urogenital complications. Therefore, this tumour is sometimes misdiagnosed. Case presentation This report described a 70-year-old woman with hematuria who was initially misdiagnosed with a bladder tumour in the outpatient department by a urologist. However, during cystoscopy, we found that the mass did not resemble a bladder tumor. Multidisciplinary approach with careful analysis of the imaging data suggested the diagnosis of osteochondroma. Open surgical excision of the mass was done and histology confirmed the diagnosis of benign osteochondroma. After 6 months of follow-up, the patient was still asymptomatic. Conclusions This case illustrates that hematuria is caused by not only urogenital disease but also osteochondroma. We present this case to draw the attention of clinicians to osteochondroma of the pubic symphysis.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Anup Singh ◽  
Vaisakh Kuzhikkali ◽  
Arvind Kumar Kairo

Abstract Background Head and neck is a relatively common site of occurrence for the peripheral nerve sheath tumors, and majority of these tumors are seen involving neck, involving vagus nerve, and cervical sympathetic chain. Schwannomas involving mobile tongue are rarely encountered, especially in the pediatric population Case presentation We present a case of recurrent tongue schwannoma in a 13-year-old female successfully managed with transoral excision. At a follow-up of 3 years, no recurrence is observed. Conclusion Surgical excision is the recommended modality of treatment for lingual schwannomas, and when excised adequately, recurrences are not expected. A clear margin of surrounding normal tissue should be aimed for to avoid possible recurrence.


2021 ◽  
pp. 875647932110668
Author(s):  
Amanda Hogan ◽  
Natalie Ullmer

Encephaloceles are considered neural tube defects, but their exact cause is unknown. The outcome is dismal, and essential management and counseling are needed for patients. Two-dimensional and three-dimensional sonography can be used to detect encephaloceles as early as 11 weeks, assist in treatment planning, and improve patient care. This case report presents an occipital encephalocele diagnosed by sonography and followed until delivery.


FACE ◽  
2021 ◽  
pp. 273250162110536
Author(s):  
Joshua Harrison ◽  
Samantha Marley ◽  
Shawhin Shahriari ◽  
Christian Bowers ◽  
Anil Shetty

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.


2013 ◽  
Vol 4 (1) ◽  
pp. 57-58
Author(s):  
Sagaya Raj ◽  
Shuaib Merchant ◽  
Azeem Mohiyuddin ◽  
P Arun

ABSTRACT Aims To describe an unusual presentation of myxoid liposarcoma of oropharynx and a brief review of literature. Introduction Liposarcomas of head and neck are very rare. Its treatment and prognosis mainly depends on the site and the histologic pattern of the tumor. Case presentation The present case report describes a 65-year-old male with complaints of dysphagia, dyspnea, and a peculiar complaint of mass in the throat which turned out to be a low-grade myxoid liposarcoma arising from right lateral wall of oropharynx extending intraluminal in the esophagus, compressing posterior wall of trachea. The mass was successfully excised surgically and postoperative period was uneventful and patient was asymptomatic 4 months after surgery. Conclusion Myxoid liposarcoma is a rare tumor in head and neck and surgical excision with adequate margin is the treatment of choice. How to cite this article Mohiyuddin A, Raj S, Merchant S, Arun P. Interesting Clinical Presentation of Myxoid Liposarcoma of Oropharynx. Int J Head and Neck Surg 2013;4(1):57-58.


2018 ◽  
Vol 28 (1) ◽  
pp. 31-36
Author(s):  
Moysés Isaac Cohen ◽  
Wander Da Silva Ferreira ◽  
Renildo Sérgio Batista Dos Anjos ◽  
Marcos Robert Da Silva Souza ◽  
Cleóstenes Farias Do Vale

Double neural tube defect is a rare congenital problem. We report a case and discuss about current theories of neural tube closure. A 39 weeks term baby with occipital encephalocele and lumbosacral myelomeningocele is reported and her managementis described. A single-staged surgery was performed. The present case is the first described in South America and seems to support a multi-site closure theory. 


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