Date et al identified a number of prognostic factors in infants with an occipital encephalocele. These can help identify patients who are more likely to have severe disabilities or early death. The authors are from Okayama University in Okayama, Japan.


Risk factors associated with a poor prognosis:

(1) presence of gross brain tissue within the encephalocele sac

(2) size of the encephalocele sac

(3) development of hydrocephalus, which may follow surgery to correct the encephalocele.


Patients who did not have adverse outcomes had a sac diameter from 1-5 cm, with a mean diameter of 2.9 +/- 0.25 cm. For the implementation I will use < 3.5 as low risk, 3.5 to 5.0 as borderline, and > 5 cm as increased risk.


An early shunting procedure may reduce the adverse impact of hydrocephalus.


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