Title: Dual Occipital encephalocele with Split cord Malformation type 1 with D8/9 level bony septum
Date: 24 December 2019
Location: Apollo Hospital, Lucknow
About the Patient and condition
A 2-day-old female child (baby of Mrs. Santoshi), who was born at another hospital and was referred to Apollo Hospitals, Lucknow with Split cord Malformation type 1 with D8/9 level bony septum between two hemicords.
Baby of Santoshi Devi, 3 days old child full term normal vaginal delivery presented here with Occipital cystic swelling since birth and thoracic spine kyphosis.
MRI Spine showed Split cord Malformation type 1 with D8/9 level bony septum between two hemicords. Cranial MRI showed Dual Occipital encephalocele with herniation of occipital lobe into the sac with no hydrocephalus with obliteration of Rt transverse sinus.
Patient was taken up for early surgery and two surgeries were performed in the same setting:
- Excision and repair of occipital encephalocele.
- D8-9 laminectomy with excision of bony septum with dural reconstruction and cord detethering with excision of intradural lipoma.
The bony septum dividing the spinal cord into two hemicords was excised. Also a lipoma compressing spinal cord was excised. The duramater was repaired and reconstructed into single dural canal.
Postoperatively child was extubated on postop day 1. Child is showed good recovery with no neurological deficits taking feeds orally.
This is a very rare case scenario where Dual Occipital encephalocele along with Split cord Malformation type 1 present in same patient. Only one such case found to be reported.
Expertise at Apollo Hospitals
The timely diagnosis and prompt actions to the case were taken by the team of neurosurgery Dr. Prarthana Saxena and Dr. Sunil Singh. Highly skilled Neurosurgeons with availability of micro neurosurgery equipments round the clock allows surgeons to perform these rare cases at Apollo Hospitals, Lucknow. Highly skilled and trained anaesthetist team and Postop care leads to better results after surgery.
Apollo Hospitals - Touching Lives
These surgeries are highly complicated due to age of baby. The surgery needs clinical expertise and well equipped operation theatre with advance equipements. Successful execution of these rare, complex and risky surgeries can only be done at well-equipped setups which are provided at Apollo Hospitals Lucknow.
Father of baby santoshi said, “My baby was just 3 days old but she is a born fighter. We took her to almost all the best hospitals in lucknow but considering her tender age, none of them agreed to take her case. Our family was completely despondent, and I feared that I would lose my baby. My head of department shared my baby’s report with the doctor over a whatsapp. Dr. Sunil immediately took up my daughter's case. My baby received immediate attention where she was examined and operated under the care of Dr. Sunil Singh and Dr. Prarthana Saxena. When we were told that the operation is successful, we had no words to express our gratitude to the doctor and his team. Apollo Hospitals Lucknow has given my daughter a new lease of life for which we will forever be grateful. This is the rebirth of my daughter."