Occipital meningoencephalocele in a newborn: A case report in East Africa

TL;DR

A rare case of occipital encephalocele in a newborn from East Africa was successfully treated surgically with minimal complications.

Contribution

This case report highlights the successful surgical management of a rare occipital encephalocele in a low-resource setting.

Findings

Occipital encephaloceles are rare in East Africa, with few reported cases.

Surgical repair in low-resource settings can achieve good outcomes with prompt post-operative care.

Hydrocephalus is a common post-surgical complication requiring timely intervention.

Abstract

Encephalocele refers to protrusion of cranial contents through a bony skull defect. Prevalence of encephaloceles in East Africa is approximately 2 per 10,000 livebirths, with occipital encephaloceles making the least proportion of these in this region. We present a case which was diagnosed postnatally and managed surgically with good outcome and few anticipated complications.

Newborn baby delivered to a 26-year-old mother at 38 weeks of gestation by spontaneous vaginal delivery, with swelling on the occipital region since birth. Physical examination revealed a mass measuring 8 cm by 6 cm over the occiput. Initial cranial ultrasound and MRI of the brain revealed an occipital myelomeningocele with part of the right cerebellar lobe, meninges, and CSF herniating through the defect in the occipital skull bone. Surgical correction was successfully done. The patient developed CSF leakage due to hydrocephalus 1-week post-surgery and VP shunt placed to relieve the increased intracranial pressure.

This case highlights a very rare neurosurgical congenital defect in East Africa that was managed as early as possible in a low resource setting with minimal post-surgical complications.

There is a need for high index of suspicion for encephalocele during antenatal ultrasound screening for prenatal diagnosis. Early surgical repair and prompt post operative follow up help to minimize complications especially in low resource settings where morbidity can be high due to high costs of managing complications.

•Occipital encephaloceles are the least common encephaloceles in Eastern Africa•Prenatal anomaly scans are important to diagnose the condition and prepare parents for post-delivery management plans.•Hydrocephalus is a common post-surgical complication that should be anticipated by prompt.•Surgical Repair in low resource settings can be achieved with good outcomes

Occipital encephaloceles are the least common encephaloceles in Eastern Africa

Prenatal anomaly scans are important to diagnose the condition and prepare parents for post-delivery management plans.

Hydrocephalus is a common post-surgical complication that should be anticipated by prompt.

Surgical Repair in low resource settings can be achieved with good outcomes

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