A ten year retrospective study on encephaloceles as seen and managed at Kenyatta National Hospital (January 1992-December 2001)
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Date
2002-11Author
Wamae, Robert N
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
This is a retrospective study of patients with cranial encephaloceles seen at the
Kenyatta National Hospital over a period of ten years from 1st January 1992 to
31st December 2001.
Eighty-nine patients with cranial encephaloceles were treated at the Kenyatta
National Hospital during that period. There were 31 males (34.8%) and 58
females(65.2%). Seventy-one patients (79.8%) were referrals from other health
care providing services. District hospitals contributed the most, 38.2% of the
patients. The youngest patient was 1 day old and the oldest was 10 years with
a mean age distribution of 5.25 months and a median of l.5 months. The
commonest age group to be operated on was between 1 month to 6 months
(39.3%) with the mode being 3 months (16.9%).
The Kikuyu with 4l.6% and Kamba with 14.6% were the commonest tribes
followed by the Luhya 11.2%, Meru 9.0%, Kalenjin 6.7%, Luo 4.5% and all
the remaining other tribes accounting for 16.9%.
Eight percent of the patients presented with leakage of cerebrospinal fluid
(CSF) from the encephalocele and seventeen percent of all patients had
ulceration of the lesion. The commonest associated congenital malformation
was hydrocephalus which was observed in 19% of the patients. Other
associated congenital malformations of the eNS were cranio vertebral junction
anomalies, Dandy walker cyst and microcephaly.Fifty seven percent of the
patients did not have any obvious associated congenital malformations.
Computerized Tomography (CT Scan) of the head was the commonest imaging
study done (42.7%), followed by ultrasonography (15.7%) and radiography
(14.6%).
Sixty one percent of the study cases had posterior encephaloceles with anterior
lesions accounting for 39%. All the patients with posterior encephaloceles
underwent excision and repair of the lesion, while 69% of the patients with
anteriorencephaloceles underwent extracranial excision and repair. Thirty one
percent of the patients with anterior encephaloceles underwent intracranial
excision and repair of the lesion. VP shunting alone without excision of the
lesionwas performed on one patient with anterior encephaloceles. Thirty three
percent of those with posterior encephaloceles had surgery for insertion of VP
shunts while for anterior lesions it was 34.4%.
The commonest complications seen m patients who underwent surgery for
cranial encephaloceles were wound infection (19.1 %), intra-operative
hemorrhage (18%) and recurrence of the lesion (12%). Eight patients (9%) died
following surgery, with four (4) of these dying within 6 weeks of surgery.
The average duration of hospital stay was 46 days although the average postoperative
hospital stay was 14 days.
Most of the patients (76.4%) attended the outpatient clinic regularly for review
for at least 12 months.
Citation
Wamae, R. N(2002).A ten year retrospective study on encephaloceles as seen and managed at Kenyatta National Hospital (January 1992-December 2001)Publisher
Department of Surgery, University of Nairobi
Description
Master of Medicine Thesis