PDF(Pubmed)
Abstract：
UNASSIGNED: Occipital encephalocele is a congenital defect of the neural tube at the level of the cranial midline, which results in herniation of meninges and brain tissue. The results of the management of myelomeningocele study determine the maternal and fetal risks for an open fetal surgery and have motivated the constant review of the concepts and strategies which the pediatric neurosurgeon can employ for the treatment of neural tube defects in the prenatal period.
UNASSIGNED: We present a case of a female patient in utero of 26 gestational weeks with the diagnosis of an occipital encephalocele treated by open fetal surgery. During week 20 of gestation, the diagnosis of occipital encephalocele was made by ultrasound, which was corroborated by fetal magnetic resonance that showed cranial protrusion of neural and meningeal content in the occipital region, measuring 1.6 × 2.8 × 3.3 cm with an approximate volume of 7.7 cc through a bone defect of 6 mm. The closure of the defect was performed by the postnatal surgical technique adapted to the open fetal surgery. Later, the patient was born transabdominal with a 2.8 cm occipital wound, with suture points and approximated borders, normocephalic, without clinical signs of sepsis, hydrocephalus, or overt neurologic compromise.
UNASSIGNED: Open fetal surgery is a therapeutic option in the face of an isolated occipital encephalocele. This case report demonstrates the viability of the surgical procedure by the adaptation of a postnatal surgical technique to a prenatal surgery. Further studies are needed to evaluate the long-term functional results, comparing them with those seen in patients who undergo a postnatal procedure.
UNASSIGNED: We present a case of a female patient in utero of 26 gestational weeks with the diagnosis of an occipital encephalocele treated by open fetal surgery. During week 20 of gestation, the diagnosis of occipital encephalocele was made by ultrasound, which was corroborated by fetal magnetic resonance that showed cranial protrusion of neural and meningeal content in the occipital region, measuring 1.6 × 2.8 × 3.3 cm with an approximate volume of 7.7 cc through a bone defect of 6 mm. The closure of the defect was performed by the postnatal surgical technique adapted to the open fetal surgery. Later, the patient was born transabdominal with a 2.8 cm occipital wound, with suture points and approximated borders, normocephalic, without clinical signs of sepsis, hydrocephalus, or overt neurologic compromise.
UNASSIGNED: Open fetal surgery is a therapeutic option in the face of an isolated occipital encephalocele. This case report demonstrates the viability of the surgical procedure by the adaptation of a postnatal surgical technique to a prenatal surgery. Further studies are needed to evaluate the long-term functional results, comparing them with those seen in patients who undergo a postnatal procedure.
摘要：
■枕骨脑膨出是颅内中线水平的神经管的先天性缺陷，导致脑膜和脑组织突出。脊髓膜膨出研究的管理结果确定了开放式胎儿手术的母体和胎儿风险，并激发了对小儿神经外科医生在产前治疗神经管缺陷的概念和策略的不断审查。
■我们介绍了一例26孕周子宫内的女性患者，诊断为通过开放式胎儿手术治疗的枕叶脑膨出。在妊娠的第20周，枕骨脑膨出的诊断是通过超声，这得到胎儿磁共振的证实，显示枕骨区神经和脑膜内容物的颅骨突出，测量1.6×2.8×3.3cm，通过6mm的骨缺损，体积约为7.7cc。缺损的闭合是通过适合开放式胎儿手术的产后手术技术进行的。稍后，病人出生时是经腹的，枕骨有2.8厘米的伤口，缝合点和近似边界，头颅正常,没有败血症的临床症状，脑积水,或明显的神经系统损害。
■面对孤立的枕骨脑膨出，开放胎儿手术是一种治疗选择。此病例报告通过将产后手术技术适应于产前手术，证明了外科手术的可行性。需要进一步的研究来评估长期功能结果，将它们与接受产后手术的患者进行比较。
■我们介绍了一例26孕周子宫内的女性患者，诊断为通过开放式胎儿手术治疗的枕叶脑膨出。在妊娠的第20周，枕骨脑膨出的诊断是通过超声，这得到胎儿磁共振的证实，显示枕骨区神经和脑膜内容物的颅骨突出，测量1.6×2.8×3.3cm，通过6mm的骨缺损，体积约为7.7cc。缺损的闭合是通过适合开放式胎儿手术的产后手术技术进行的。稍后，病人出生时是经腹的，枕骨有2.8厘米的伤口，缝合点和近似边界，头颅正常,没有败血症的临床症状，脑积水,或明显的神经系统损害。
■面对孤立的枕骨脑膨出，开放胎儿手术是一种治疗选择。此病例报告通过将产后手术技术适应于产前手术，证明了外科手术的可行性。需要进一步的研究来评估长期功能结果，将它们与接受产后手术的患者进行比较。
