Management of the giant occipital encephaloceles in the neonates

- Lateral position is considered to be safer than the supine position for endotracheal intubation during surgery, because the weight of the head is not transmitted to the sac; this eliminates the risk of compression-related preoperative rupture of the sac, or an inadvertent incresae in the intracranial pressure.
- Intraoperative blood and CSF loss, hypothermia, bradycardia and cardiac arrest are most important problems for surgery of giant occipital encephalocele.
- The size of the encephalocele and the amount of neural tissue found in the sac correlates with the prognosis.
- Neurological outcome depends upon the presence or absence of hydrocephaly, while intelligence level is mainly related to the absence of brain tissue into the sac.
- Careful planned and early meticulous surgery results in a satisfactory outcome.