Growth and psychological development in post-operative patients of anterior encephaloceles

Publication date: Available online 8 February 2017
Source:Pediatric Neurology
Author(s): Hemonta K. Dutta, C. Wachana Khangkeo, Kaberi Baruah, Debasish Borbora
PurposeAnterior encephaloceles are rare malformations frequently associated with other brain anomalies. This study evaluates the growth and psychological development of children following encephalocele repair.Materials & methodsGrowth and psychological assessment was done in 24 children with only encephalocele (group-I), 9 children with encephalocele and hydrocephalus (group-II), 7 children with encephalocele, hydrocephalus and secondary malformations (group-III) and 40 apparently healthy controls. Psychological assessment was done by evaluating intelligence and temperament.ResultsSingle-stage repair was performed in 38 children, 2 underwent multistage repair. Major post-operative complications were noted in 3 patients. The follow-up period ranged from 12 to 168 months, during which the growth velocity declined significantly among group-II and group-III patients when compared to controls. After age-adjusting body mass index (BMI), our data revealed that group-III participants had a significantly (p=0.02) lower BMI than the control group. Group III also had poor indices for intelligence quotient (IQ) (p≤0.01) and temperament (p≤0.01). Female patients had lower temperament indices as compared to unaffected females- approach withdrawal (p≤0.01), mood (p=0.026) and intensity (p=0.03). Overall, increased disease severity adversely affected psychological indices.ConclusionAnterior encephalocele patients without associated intracranial defects had excellent post-operative outcomes in terms of growth and psychological developments. Hydrocephalus and agenesis of corpus callosum had least impact on the psychological development. However the presence of secondary brain defects led to developmental delays. Gender differences in temperament explains the need for distinct treatment regimen to assess psychosocial well-being for male and female cases.



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