Congenital duplication of the superior sagittal sinus and parietal encephalocele after vacuum extraction delivery.
A newly-born infant with a congenital dural and bony defect and an associated short-segmented duplication of the superior sagittal sinus suffered from herniation and infarction of parietal brain tissue secondary to vacuum extraction. This ultimately led to the formation of a subgaleal cerebrospinal fluid (CSF) collection. Initial operative closure of the encephalocele was performed by attaching a galeal flap to the periostium surrounding the congenital defect. As the bony defect developed characteristics of a growing fracture later on, dural repair, transplantation of a split-bone flap and, finally, the insertion of a ventriculoperitoneal shunt became necessary. This case affirms that stringent indication and cautious usage of vacuum-assisted delivery is strongly recommended, especially in view of the possibility that undetected congenital cranial, vascular and/or cerebral alterations may be present.
Neumann
Jan-Oliver
JO
Department of Neurosurgery, Universitätsklinikum Heidelberg, Heidelberg, Germany. Jan-Oliver.Neumann@med.uni-heidelberg.de
Herweh
Christian
C
Halatsch
Marc-Eric
ME
D001720:Birth Injuries / Q000175:diagnosis / Q000601:surgery*; D016025:Bone Transplantation; D020520:Brain Infarction / Q000175:diagnosis / Q000601:surgery*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000601:surgery*; D003399:Craniotomy; D004388:Dura Mater / Q000002:abnormalities; D004677:Encephalocele / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D010296:Parietal Lobe / Q000098:blood supply*; D011247:Pregnancy; D012086:Reoperation; D012307:Risk Factors; D012886:Skull / Q000002:abnormalities; D054063:Superior Sagittal Sinus / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects*; D017287:Ventriculoperitoneal Shunt