Occipital Encephalocele: Unraveling Clinical Presentation and Optimizing Surgical Outcomes

A bstract Background: Encephaloceles are rare congenital defects where the brain tissue protrudes through an opening in the skull, often accompanied by meninges and cerebrospinal fluid (CSF). The occipital region is the most common site for this condition. The prognosis is influenced by factors such as the size of the sac, presence of neural tissue, and associated complications. Objective: This study aims to assess the clinical presentation, diagnostic procedures, surgical management, postoperative complications, and long-term outcomes of patients with occipital encephalocele. Materials and Methods: A retrospective analysis was performed on 26 patients who underwent occipital encephalocele repair at the Department of Neurosurgery, BYL Nair Hospital, Mumbai, between March 2017 and April 2022. The data collected included patient demographics, clinical symptoms, imaging findings, surgical details, and follow-up outcomes. All patients were monitored for at least 1 year post-surgery. Results: The median age at presentation was 5.2 months, with a slight female predominance. Hydrocephalus was observed in six cases. Surgical procedures involved excision of herniated neural tissue and watertight dura closure with ventriculoperitoneal shunts placed in hydrocephalus cases. Postoperative complications included CSF leak (11.5%), infection (19.2%), meningitis (7.7%), and seizures (7.7%). One patient died due to aspiration pneumonia, resulting in a mortality rate of 3.8%. No recurrences were noted in the follow-up period (mean 15.5 months). Conclusion: Timely surgical intervention and careful postoperative management of wound are crucial for improving outcomes in occipital encephalocele. Despite common complications, most patients showed significant recovery with appropriate care.