Hideo Ohba1, Satoshi Yamaguchi2, Takashi Sadatomo3, Masaaki Takeda2, Manish Kolakshyapati2, Kaoru Kurisu2. 1. Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan. m.d.hideoohba1208@gmail.com. 2. Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan. 3. Department of Neurosurgery, National Hospital Organization Higashihiroshima Medical Center, 513, Jike, Saijo-cho, Higashihiroshima, Hiroshima, 739-0041, Japan.
Abstract
INTRODUCTION: The first-line treatment of encephalocele is reduction of herniated structures. Large irreducible encephalocele entails resection of the lesion. In such case, it is essential to ascertain preoperatively if the herniated structure encloses critical venous drainage. CASE REPORTS: Two cases of encephalocele presenting with large occipital mass underwent magnetic resonance (MR) imaging. In first case, the skin mass enclosed the broad space containing cerebrospinal fluid and a part of occipital lobe and cerebellum. The second case had occipital mass harboring a large portion of cerebrum enclosing dilated ventricular space. Both cases had common venous anomalies such as split superior sagittal sinus and high-positioned torcular herophili. They underwent resection of encephalocele without subsequent venous congestion. We could explain the pattern of venous anomalies in encephalocele based on normal developmental theory. CONCLUSION: Developmental theory connotes that major dural sinuses cannot herniate into the sac of encephalocele. Irrespective to its size, encephalocele can be resected safely at the neck without subsequent venous congestion.
INTRODUCTION: The first-line treatment of encephalocele is reduction of herniated structures. Large irreducible encephalocele entails resection of the lesion. In such case, it is essential to ascertain preoperatively if the herniated structure encloses critical venous drainage. CASE REPORTS: Two cases of encephalocele presenting with large occipital mass underwent magnetic resonance (MR) imaging. In first case, the skin mass enclosed the broad space containing cerebrospinal fluid and a part of occipital lobe and cerebellum. The second case had occipital mass harboring a large portion of cerebrum enclosing dilated ventricular space. Both cases had common venous anomalies such as split superior sagittal sinus and high-positioned torcular herophili. They underwent resection of encephalocele without subsequent venous congestion. We could explain the pattern of venous anomalies in encephalocele based on normal developmental theory. CONCLUSION: Developmental theory connotes that major dural sinuses cannot herniate into the sac of encephalocele. Irrespective to its size, encephalocele can be resected safely at the neck without subsequent venous congestion.
Authors: F Brunelle; J Baraton; D Renier; D Teillac; I Simon; P Sonigo; L Hertz-Pannier; S Emond; N Boddaert; V Chigot; A Lellouch-Tubiana Journal: Pediatr Radiol Date: 2000-11