Một số encephaloceles cơ bản, tuy nhiên, có thể làm xói mòn thông qua một màng cứng suy yếu, dẫn tới rò rỉ dịch não tủy và có nguy cơ cao của bệnh viêm màng não. Sự tham gia của cuống tuyến yên hoặc các cấu trúc xung quanh Sella có thể sản xuất một endocrinopathy. Đệm thoát vị não mô có thể gây mù lòa từ nén của các dây thần kinh thị giác | 172 Pediatric Neurosurgery are covered by normal skin and do not require urgent repair. Some basal encephaloceles however can erode through an attenuated dura leading to a CSF leak and a higher risk of meningitis. Involvement of the pituitary stalk or structures around the sella may produce an endocrinopathy. Herniated brain tissue can cause blindness from compression of the optic nerve. Poorer outcome is associated with increased amount of brain material within the sac and with the presence of hydrocephalus. 9 Treatment Lesions with exposed neural tissue or an obvious CSF leak should be repaired urgently. Treatment of lesions with normal skin coverage can be deferred until a later time for definitive repair. As with craniofacial syndromes staged repair maybe necessary for anterior encephaloceles with significant facial remodeling and distortion. Surgical repair involves defining the margins of the normal anatomical structures isolating the transition from normal to dysplastic brain tissue within the sac truncating this tissue and performing a watertight dural closure. For posterior encephaloceles in particular the location of the dural venous sinuses must be determined preoperatively to prevent accidental entry and major blood loss. MRI and CT venography are ideal methods for defining the anatomic relationship between the superior sagittal sinus and torcula and the dural defect and encephalocele sac. The subsequent reconstruction of the bone may require bone grafts with autologous bone or synthetic material. If hydrocephalus is present the only way to prevent a CSF leak may be to insert a VP shunt. Craniofacial Tumors Benign congenital tumors of the skull base include dermoid tumors teratomas and hemangiomas. The clinical presentation in infancy includes facial asymmetry a visible or palpable mass in the nose or mouth or a cutaneous marker such as a deep dimple in the midline from the tip of the nose to the anterior fontanelle. Congenital tumors may occasionally .
