Each month, the Boston Africa Anesthesia Collaborative (BAAC) hosts grand rounds to promote case-based learning and knowledge exchange in anesthesia practice across resource-limited settings in Liberia. The May session focused on best practices for managing neonates with encephalocele.

Encephalocele is a congenital neural tube defect characterized by incomplete closure of the cranial vault, leading to the herniation of brain tissue through a defect in the skull. It is typically classified based on its location into anterior and posterior types. The clinical presentation of encephalocele varies depending on the size and location of the defect. Symptoms may include headache, visual disturbances, muscle weakness, microcephaly (small head size at birth), ataxia, facial malformations, nasal obstruction, and cerebrospinal fluid (CSF) leakage from the nose or ear Long-term complications associated with encephalocele can include developmental delays, cognitive impairment, vision problems, growth retardation, and seizures.

While encephalocele is primarily congenital, some cases arise secondary to trauma or tumors. Associated syndromes include Walker-Warburg syndrome, Knobloch syndrome, Roberts syndrome, and Amniotic band syndrome. Risk factors include a family history of neural tube defects and inadequate maternal folic acid intake before and during pregnancy. Prenatal ultrasound and/or MRI can identify encephalocele in utero. Postnatal imaging assists in surgical planning and assessment of associated brain anomalies. Surgical intervention involves repair of the skull defect and excision of herniated brain tissue to prevent infection and further neurological compromise.