case_images: PMC10783659_01
case_images: Obstetric ultrasound during week 20 of gestation with occipital encephalocele.
case_images: SNI-14-433-g001.jpg
case_images: PMC10783659_01_SNI-14-433-g001.jpg
case_images: F1
case_images: During week 20 of gestation, an obstetric ultrasound is performed, which reveals an occipital encephalocele [Figure 1].
case_images: Sagittal view of fetal magnetic resonance T2 weighted image showing an occipital protrusion measuring 1.6 x 2.8 x 3.3 cm
case_images: SNI-14-433-g002.jpg
case_images: PMC10783659_01_SNI-14-433-g002.jpg
case_images: F2
case_images: Axial view of fetal magnetic resonance T2 weighted image showing an occipital protrusion with a bone defect of 6 mm.
case_images: SNI-14-433-g003.jpg
case_images: PMC10783659_01_SNI-14-433-g003.jpg
case_images: F3
case_images: Coronal view of fetal magnetic resonance T2 weighted image showing an occipital protrusion with an estimated volume of 7.7 cc.
case_images: SNI-14-433-g004.jpg
case_images: PMC10783659_01_SNI-14-433-g004.jpg
case_images: F4
case_images: Surgical technique. (a) Localization of placenta by transoperative echography, planning of mini hysterotomy. (b) A 3 cm mini hysterotomy and widening by a Weitlaner retractor. (c) Exposure of occipital encephalocele. (d) Midline incision of encephalocele sac and exposure of meninges. (e) Tight closure of meninges by a 5-0 propylene running suture. (f) Complete closure of occipital defect without leak of cerebrospinal fluid (CSF). (g) Postnatal wound of clinical case with borders closed with a running suture, without leak of CSF.
case_images: SNI-14-433-g005.jpg
case_images: PMC10783659_01_SNI-14-433-g005.jpg
case_images: F5
case_images: A 3 cm longitudinal mini-hysterotomy was performed [Figures 5a-b]. The repair of the encephalocele starts with a midline incision of the hernial sac [Figure 5c]. Then, exposure of meninges and circumferential dissection is carried out, followed by cutting at the level of the external table of the occipital bone by means of micro scissors and monopolar at a very low intensity [Figure 5d]. The protruded neural tissue was returned to its intracranial position, and a tight closure of the meningeal layers with a 5-0 propylene running suture was completed [Figure 5e]. After the repair of the occipital encephalocele, the fetus was returned to the uterine cavity [Figure 5f].