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NEUROIMAGING |
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| Year : 2006 | Volume
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| Issue : 2 | Page : 72 |
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Quadrigeminal cistern herniating into an occipital encephalocele
Manish Kumar Kasliwal, Deepak K Gupta, Ashok K Mahapatra
Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
Correspondence Address:
Ashok K Mahapatra
Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi - 110 029
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1817-1745.27459
How to cite this article:
Kasliwal MK, Gupta DK, Mahapatra AK. Quadrigeminal cistern herniating into an occipital encephalocele. J Pediatr Neurosci 2006;1:72 |
A 1-year-old child was admitted to our department with complaints of rapidly enlarging head and a swelling at the back of head with delayed developmental milestones. On examination, the child had an enlarged head with tense anterior fontanelle. There was a soft compressible nonpulsatile swelling at the back of occiput with a bony defect. A diagnosis of occipital encephalocele with associated hydrocephalus was made. Magnetic resonance imaging done to confirm the diagnosis and rule out a myriad of other associated anomalies revealed gross hydrocephalus along with an occipital encephalocele consisting of minimal brain tissue filled with cerebrospinal fluid (CSF) with the quadrigeminal cistern and ventricular system herniation into it [Figure - 1],[Figure - 2]. Surgery was performed, and a ventriculo-peritoneal shunt along with the repair of encephalocele was done. The child had an uneventful postoperative course.
 Discussion | |  |
A cephalocele is a protrusion of the cranial contents beyond the normal confines of the skull and can be a meningocele, encephalomeningocele or a hydroencephalomeningocele, which consists of a herniation of brain tissue, meninges and a portion of ventricles in the sac.[1] The images presented here quite clearly depict the quadrigeminal cistern herniating into the sac. The prognosis of these congenital lesions is guarded, with the posterior ones having a worse prognosis than the anterior encephaloceles. Presence of neural tissue in the sac and associated hydrocephalus requiring shunt predicts a worse prognosis in posterior encephaloceles.[2] The management of these lesions can be quite challenging, often due to associated hydrocephalus. Though the operative morbidity and mortality have became quite low, quite a number of children are impaired due to the presence of associated malformations.[1],[2]
| References | | |
| 1. | Simpson DA, David DJ, White J. Cephaloceles: Treatment, outcome and antenatal diagnosis. Neurosurgery 1984;15:14-21.  [PUBMED] [FULLTEXT] |
| 2. | Brown MS, Sheridan-Pereira M. Outlook for the child with a cephalocele. Pediatrics 1992;90:914-9. [PUBMED] [FULLTEXT] |
Figures
[Figure - 1], [Figure - 2]
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