INTRODUCTION
Encephalocele is the herniation of meninges and
brain tissue outside the cranium usually, but not
always, in the midline. As with spina bifida, the
outcomes for encephalocele cases vary depending on
the size of the lesion and the presence of other
structural anomalies. As with other neural tube defects
there are reported associations with maternal insulin
dependent diabetes, hyperthermia, obesity at conception,
autosomal trisomies, and low serum folate concentrations.
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ANTENATAL
Programmes for the prenatal diagnosis of neural
tube defects are well developed in the West Midlands.
Two methods of screening are in use, often together.
The first is maternal serum AFP screening performed
at 16 to 20 weeks gestation, the second is ultrasound
screening, which is widely performed at 16 to 22
weeks for this purpose. AFP serum screening is less
effective for encephalocele, which is usually skin
covered and therefore not amenable to this technique.
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POSTNATAL
Encephalocele is similar to spina bifida in the
variety of outcomes. Associated structural anomalies
are relatively common, particularly renal anomalies,
and need to be considered before other interventions
are planned. Lesions may contain cerebrospinal fluid
only or a varying amount of brain or spinal tissue.
The prognosis depends on the size of the lesion,
and associated CNS dysfunction. Small lesions containing
little or no brain substance will tend to have a
good prognosis.
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WEST
MIDLANDS DATA
To be added.
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