Complications of Therapies for Atretic Encephaloceles in Children

Surgery

• Excessive blood loss: Usually, repair of an atretic encephalocele is a simple procedure that does not entail significant risk. However, the possibility of an accidental tear of the sagittal sinus should always be taken into account. Careful dissection and division of the malformation stalk flush with the dura mater prevents inadvertent damage to the sagittal sinus with subsequent hemorrhage. Should bleeding occur, the hemorrhage can be stopped by gentle digital compression of the sinus with the aid of a surgical patty and with the application of an absorbable fibrin sealant patch.
• Infections, superficial or deep: Careful skin preparation usually prevents superficial or deep infection. Prophylactic antibiotics are recommended by most authors. A wound infection may be treated as a scalp infection at other cranial locations.
• Wound dehiscence: Wound dehiscence is rare. It may be treated with approximation stitches or adhesive strips.