Fact-sheet: Encephalocele
Updated on 09/17/2021 at 12:16 PM
View all RADEOS cases associated with this fact-sheet
Definition
Congenital herniation of one or more cerebral structures through a bony defect.
- meningocele: herniation of meninges and CSF
- meningoencephalocele: meninges + CSF + brain parenchyma
Typical locations:
- fronto-nasal
- occipital
- vertex (atretic)
Clinical features
Depending on location: - occipital: clinically visible as a subcutaneous mass. - fronto-nasal: clear nasal discharge, mass effect with its complications (retention sinusitis...) For all locations: - recurrent meningitis - neurologic deficit, developmental delay
CT
Key preoperative imaging to precisely visualize the relationships and osseous, vascular remodeling.
MRI
SE T1: Good visualization of displacement of cerebral structures, vessels, cisterns/ventricles within the encephalocele. SE T2 (sagittal ++): Key sequence! - better distinction of cerebral structures, vessels, cisterns/ventricles within the encephalocele. - looks for elevation of the straight sinus or elongation of the supravermian cistern in atretic locations. T2*: Looks for hemorrhagic complications. T1 with gadolinium: Allows differential diagnosis with a nasopharyngeal tumor that enhances.
Management
Perform MRI and CT as complementary studies.
Depending on the clinical picture, look for other midline anomalies at the cerebral level but also at the spinal level (spina bifida).
Differential diagnosis
- dermoid cyst (diffusion restriction)
- infantile capillary hemangioma
- nasopharyngeal tumors (enhance)