Occipital encephalocele: a retrospective analysis and assessment of post-surgical neurodevelopmental outcome.

Background: Encephalocele represent a group of disorders which is characterised by extracranial herniation of the leptomeninges, brain, and CSF through a structural defect in the cranium. They are usually associated with other intracranial anomalies which may impact the neurological development.
Aim: This study aimed to assess the predictors of neurological development of patients undergone surgical excision of occipital encephalocele.
Methods: All patients with occipital encephaloceles operated over the last decade (2012-2022). The sac size, presence of hydrocephalous, and associated anomalies were noted. The biopsy of these patients were reviewed and categorised as those which contains mature neural tissue and those without. The neurological outcomes were assessed by social, language, cognitive, and motor milestone and has been stratified into no delay, mild (1 of 4), moderate (2 or 3 of 4), and severe development delay (4 of 4).
Results: Total of 35 patients were included with median age of 10 months (IQR = 5-20 months). Fifteen (42.9%) patients had sac size of ≥ 5 cm, and 23 (65.7%) patients had mature neural tissues on biopsy. The median follow-up period was 6.4 years (IQR = 4.38-10.65) years. Seventeen (49.6%) patients had moderate to severe developmental delay. The sac size of ≥ 5 cm (AOR = 33.5; 95%CI = 3.35-334.8) (p = 0.003) and presence of mature neural content in the sac (AOR = 13.32; 95%CI = 1.1-160.36) (p = 0.041) were associated with significant neurodevelopmental delay.
Conclusion: The presence of a large sac of ≥ 5 cm and the presence of mature neural tissues on histopathological specimen of patients with encephalocele point towards the possibility of poor neurological development.
Competing Interests: Declarations: I, Dr Pawan Kumar Verma, certify that this manuscript is a unique submission and is not being considered for publication, in part or in full, with any other source in any medium. Ethics approval: This is an observational study. The Institutional Ethics Committee has confirmed that no ethical approval is required. Consent to participate: As this a retrospective study, the patients’ consent to participate were waived off by the Institutional Ethics Committee. Consent for publication: The manuscript does not contain any information from which a patient’s identity could be disclosed. Conflict of interests: The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)