Recovery After Surgery for Cervical Encephaloceles in Children

Postoperative Orders 

• ICU vs. standard care unit: Patients recover initially in an intensive care unit setting. 
• Ventilator support: Depending on the contents of the encephalocele, associated syndromes, cerebral anomalies, and ease of surgical correction, some patients may require mechanical ventilatory support and tube feeding postoperatively.  If weaning to extubation fails, the patient may require tracheostomy placement for ventilatory support. 
• Diet: If dysphagia and/or aspiration are present, a gastrostomy tube may be required postoperatively for nutritional supplementation. 
• Wound management: The incision should be monitored closely for breakdown, infection, and CSF leak.  If a CSF leak occurs, the patient should be evaluated for hydrocephalus and the need for CSF diversion by means of shunting. 
• Postoperative MRI: A brain MRI, MRA, and MRV and a full spine MRI should be obtained postoperatively to evaluate the morphology of the remaining brain and spinal cord tissue, including the vasculature, and to provide a baseline for future comparison.

Postoperative Morbidity

• Neck discomfort: Routine muscle-skeletal discomfort can be expected.