Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 444
 
About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Advertise Login 
     


 
 Table of Contents  
CASE REPORT
Year : 2019  |  Volume : 8  |  Issue : 3  |  Page : 176-177

Double encephalocele arising from single bone defect: A rare case


Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India

Date of Web Publication6-Aug-2019

Correspondence Address:
Dr. Aditya Pratap Singh
Near the Mali Hostel, Main Bali Road, Falna, Pali District - 306 116, Rajasthan
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcn.JCN_10_19

Rights and Permissions
  Abstract 


Encephalocele is the protrusion of the cranial contents beyond the normal confines of the skull through a defect in the calvarium. The occurrence of more than one encephalocele in a patient is very rare, and very few cases of double encephalocele have been reported. We report here a case of double encephalocele over the occipital area in a newborn. At the time of surgery, we found that both were arising from a single bone defect with separate sac. Both were repaired, and the patient was discharged uneventfully.

Keywords: Double, encephalocele, newborn


How to cite this article:
Garg D, Singh AP, Tanger R, Gupta AK. Double encephalocele arising from single bone defect: A rare case. J Clin Neonatol 2019;8:176-7

How to cite this URL:
Garg D, Singh AP, Tanger R, Gupta AK. Double encephalocele arising from single bone defect: A rare case. J Clin Neonatol [serial online] 2019 [cited 2019 Sep 21];8:176-7. Available from: http://www.jcnonweb.com/text.asp?2019/8/3/176/264030




  Introduction Top


Encephalocele is a congenital malformation characterized by protrusion of the brain tissue due to a skull defect.[1] Based on the location of the skull defect, they are classified into sincipital, basal, occipital, or parietal varieties. It is a neural tube defect. Other neural tube defects are anencephaly and spina bifida. Neural tube defects are caused by the abnormal closure of the embryonic neural tube between 22 and 28 days after conception. The resulting structural defects, which may occur anywhere along the neuraxis.[2],[3]


  Case Report Top


A newborn male child came in an emergency with a complaint of scalp swelling since birth. On examination, we found two swellings in the occipital region [Figure 1]. The sizes of both swellings were 4 cm × 4 cm and 2 cm × 2 cm. There were no neurological deficits preoperatively. There was no family history. Routine blood investigations were within normal limits. The patient was admitted and prepared for surgery. The size of the defect was around 2 cm × 1.5 cm. we tried to reduce the content but could not possible. Decapping and repair were done with resection of the mass. During the surgery, we found that both swellings were arising from a single bone defect with separate sac. Both sacs were repaired separately. Postoperatively, the patient did well and discharged uneventfully. There have been no neurological deficits or hydrocephalus in follow-up for the last 1 year.
Figure 1: Photograph showing double occipital encephalocele

Click here to view



  Discussion Top


The main cause of neural tube defects are abnormalities that occur during neurulation, which should be complete by 4 weeks postconception.[4] The occipital region is the most common location (75%), and encephaloceles in this region are frequently associated with other malformations such as agenesis of the corpus callosum, Chiari II malformation, and Dandy–Walker syndrome.[5]

Double encephalocele is very rare and only few cases are reported.[6],[7] In all reported cases, patients had separate bone defect. Our case is unique because both sacs were arising from a single bone defect.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Acknowledgment

We would like to acknowledge Dr. Neelam Dogra, MD Anaesthesia, Senior Professor, SMS Medical College Jaipur.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Suwanwela C, Sukabote C, Suwanwela N. Frontoethmoidal encephalomeningocele. Surgery 1971;69:617-25.  Back to cited text no. 1
    
2.
Grillo E, da Silva RJ. Neural tube defects and congenital hydrocephalus. Why is prevalence important?. J Pediatr (Rio J) 2003;79:105-6.  Back to cited text no. 2
    
3.
Tamura T, Picciano MF. Folate and human reproduction. Am J Clin Nutr 2006;83:993-1016.  Back to cited text no. 3
    
4.
American Academy of Pediatrics, Committee on Genetics. Folic acid for the prevention of neural tube defects. Pediatrics 1999;104:325-7.  Back to cited text no. 4
    
5.
Kosnik EJ, Meagher JN, Quenemoen LR. Parietal intradiploic encephalocele. Case report. J Neurosurg 1976;44:617-9.  Back to cited text no. 5
    
6.
Canaz H, Ayçiçek E, Akçetin MA, Akdemir O, Alataş I, Özdemir B. Supra- and infra-torcular double occipital encephalocele. Neurocirugia (Astur) 2015;26:43-7.  Back to cited text no. 6
    
7.
Sharma S, Ojha BK, Chandra A, Singh SK, Srivastava C. Parietal and occipital encephalocele in same child: A rarest variety of double encephalocele. Eur J Paediatr Neurol 2016;20:493-6.  Back to cited text no. 7
    


    Figures

  [Figure 1]



 

Top
 
 
  Search
 
Similar in PUBMED
  Search Pubmed for
  Search in Google Scholar for
Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Case Report
Discussion
References
Article Figures

 Article Access Statistics
    Viewed107    
    Printed0    
    Emailed0    
    PDF Downloaded16    
    Comments [Add]    

Recommend this journal