Bülent KÖSTÜ, Önder ERCAN, Deniz Cemgil ARIKAN, Fazıl AVCI, Murat BAKACAK, Salih SERİN

Paryetal Ensefalosel: Olgu Sunumu

Nöral tüp defektleri konjenital anomaliler içerisinde en sık görülen ikinci anomalidir. Biz bu olgu sunumunda prenatal dönemde tanı konulan ensefaloselin nadir görülen bir tipi olan paryetal ensefaloselli bir olguyu sunmayı amaçladık. Olgumuz 26 yaşındaydı ve son adet tarihine göre 18 haftalık gebeliği mevcuttu. Yapılan iki boyutlu ultrasonografik taramasında; fetusun sağ parietal bölgesinde yerleşimli, yaklaşık olarak boyutu 49 x 41 mm olan, ventrikülomegalinin de eşlik ettiği ensefalosel kesesi izlenmiştir. Teknolojik gelişmeler ve herniye olan kesenin içeriğinin belirlenmesiyle, erken gebelik haftalarında tanının konulmasının ardından ailelere kliniğin prognozu hakkında bilgi verilmelidir. Paryetal bölgede yerleşimli ensefalosel olgularında, ailelere gebeliğin sonlandırılması tavsiye edilmelidir. Bizim olgumuzda; fetusa ekstrakranyal ve kardiyak anomaliler açısından tarama yapıldı ve amniyosentez uygulandı. Ailenin de onayı alınarak gebeliğin terminasyonu gerçekleştirildi.

Anahtar Kelimeler:

Prenatal tanı, paryetal ensefalosel, gebelik terminasyonu

A Case Report: Parietal Encephalocele

Neural tube defects are the second most common type of congenital anomalies. The purpose of this case report is to present a case with parietal encephalocele, a rare type of encephalocelediagnosed in the prenatal period.The reported case was 26 years old at 18 weeks of gestation by last menstrual period. The two-dimensional ultrasound showed an encephalocelesac located in the right parietal lobe of the fetus, size approximately 49 x 41 mm, presenting also with ventriculomegaly. One the contents of the hernia sac has been identified, parents should be informed during early gestational weeks about the prognosis of the clinical outcome and of technological developments following final diagnosis. Termination of pregnancy should be recommended to the families in cases with parietal encephalocele. In the present case, fetal ultrasound examination for extracranial and cardiac anomalies and amniocentese were performed. The pregnancy was terminated with the consent of the parents.

Keywords:

Prenatal diagnosis, parietal encephalocele, termination of pregnancy,

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Nyberg DA, McGahan JP, Pretorius DH, Pilu G(editors). Diagnostic Imaging of Fetal Anomalies. Neural Tube Defects and the Spine. 291- 333.
Tsai PY, Chang CH, Chang FM. Prenatal diagnosis of the fetal frontal encephalocele by three-dimensional ultrasound. Prenat Diagn. 2006; 26: 378-80.
Onrat ST, Seyman H, Konuk M. Incidence of neural tube defects in Afyonkarahisar, Western Turkey. Genet Mol Res. 2009; 8: 154-61.
Cameron M, Moran P. Prenatal screening and diagnosis of neural tube defects. Prenat Diagn. 2009; 29: 402-11.
Sing-Ling Liao, Pei-Yin Tsai, Yueh-Chin Cheng, Chiung-Hsin Chang, Huei- Chen Ko, Fong-Ming Chang. Prenatal Diagnosis of Fetal Encephalocele Using Three-dimensional Ultrasound, Journal of Medical Ultrasound 2012; 20: 150-4.
Lo BW, Kulkarni AV, Rutka JT, Jea A, Drake JM, Lamberti-Pasculli M, Dirks PB, Thabane L. Clinical predictors of developmental outcome in patients with cephaloceles. J Neurosurg Pediatr. 2008; 2: 254-7.
Matson DD: Neurosurgery of Infancy and Childhood, ikinci baskı, Springfield: Charles C Thomas, 1969: 61-75.
Chen CP. Chromosomal abnormalities associated with neural tube defects (I) : full aneuploidy. Taiwan J Obstet Gynecol. 2007; 46: 325-35.
Gun Y, Suk-Joo C, Cheong-Rae R, Jong-Hwa K. An antenatally diagnosed huge non-syndromic encephalocele with successful term delivery and postnatal management. Journal of Women’s Medicine. 2010; 3: 117-21.
Youngblood ME, Williamson R, Bell KN, Johnson Q, Kancherla V, and Oakley GP. 2012 Update on Global Prevention of Folic Acid–Preventable Spina Bifida and Anencephaly. Birth Defects Research (Part A): Clinical and Molecular Teratology. 2013; 97: 658–63.
Bailey LB, Rampersaud GC, Kauwell GP. Folic acid supplements and fortification affect the risk for neural tube defects, vascular disease and cancer: evolving science. J Nutr. 2003; 133:1961-8.
Luthy DA, Wardinsky T, Shurtleff DB, Hollenbach KA, Hickok DE, Nyberg DA, Benedetti TJ. Cesarean section before the onset of labor and subsequent motor function in infants with meningomyelocele diagnosed antenatally. N Engl J Med. 1991; 324: 662-6.