How folic acid during pregnancy can prevent brain cyst of the type AIIMS doctors removed in baby

When Abid Azad had twin sons, he celebrated like any father. But then three months later he didn’t think he could lose one of them. One of his twins, his Arhat Aydin, had a huge encephalocele or cyst that had spilled out of his brain. It grew larger than his head and threatened to take his life. Turned down by many experts, Azad, a Bangladeshi, traveled all the way to Delhi, where AIIMS doctors attempted a rare operation that saved his life.

“I contacted many doctors in private hospitals in Delhi, but they refused to treat me. says Azad, a communications specialist at USAid in Bangladesh. As a last resort, he came to his AIIMS and his wife Sadia Yeasmin has returned to take care of her one more twin and her six-year-old son. He fed, cared for and watched over his son until he had surgery. What do we know about this rare genetic defect?

What is an encephalocele?

According to the Centers of Disease Control (CDC), an encephalocele is a sac-like protrusion or protrusion of the brain and overlying membranes through an opening in the skull. It is a rare birth defect that occurs when the neural tube does not close completely during pregnancy. The result is an opening somewhere along the center of the skull from the nose to the back of the neck, but most often at the back of the head, on the top of the head, or between the forehead and the nose. hinder. In some cases, cerebrospinal fluid or the membrane that covers the brain (meninges) leaks through this gap into the thin sac, which can rupture.

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Most encephaloceles are large and can be diagnosed before birth. However, in very rare cases, some encephaloceles are small and may go unnoticed.

How AIIMS Doctors Overcame Challenges

The surgery was performed on 12th December at AIIMS Delhi by a team of doctors led by Dr. Deepak Gupta, Professor of Neurosurgery.

“We noticed that the sac was leaking cerebrospinal fluid. Baby had a history of pus draining from the sac and a large swelling on his back that made it difficult to position, feed and feed. Brain tissue. There was a danger that the sac containing the cyst could rupture at any time, which could lead to meningitis and death in the infant,” he said. Attempted skull reconstruction. In a three-hour operation, the cyst was removed and the skull expanded to cover the working part of the brain. “After assessing the baby’s condition, it was decided to perform the operation. The operation was performed on December 12th to remove a non-functional protrusion of the brain in the form of a cyst and to remove all the normal brain tissue. Tissues were preserved and an extended cranioplasty was performed to give space to the brain.

cyst brain cyst aiims delhi health folate pregnancy indian express Arhat Aydin had a huge cyst that had spilled out of his brain, making it larger than his head.

Surgery is the only option, when should it be done?

According to the CDC, surgery is usually done between the ages of 4 months and up, depending on the size, location, associated complications, and whether the encephalocele is covered by a layer of skin. If the skin is thick enough to act like a protective cover, surgery can be delayed for months.

The surgical protocol usually involves pushing the protruding contents of the encephalocele back into the skull. A neurosurgeon usually removes part of the skull to give access to the brain. He then cuts open the dura mater, the hard outer covering of the brain, pushing the herniated portion of the brain, meninges, and fluid back into the skull and removing the surrounding sac. It is important to note that you can do In some cases, multiple surgeries may be required.

According to the National Organization for Rare Diseases (NORD), “additional treatment is based on the specific symptoms seen in each individual case. It can be treated with a transplant.”

Can this birth defect be stopped?

According to Dr. Gupta, in this case the parents did not take folic acid tablets and should take folic acid tablets if they are planning to become pregnant (first trimester) to prevent neural tube defects in the fetus. It is a well-known fact that this is not the case.

He adds that women trying to conceive should consume 400 micrograms of folic acid daily from fortified foods and/or supplements, in addition to what they get from their normal diet. 12 might also make up for it.

The surgery was performed under the initiative of Universal Health Coverage Day, an initiative of the United Nations and WHO to make health accessible throughout the universe. Six days after surgery, the baby is doing well and will likely be discharged from the hospital on Monday, Abid said.

“All doctors told me that skull reconstruction is not possible, but today my child is safe and healthy after surgery. “They are brave parents who have two babies in two countries,” Dr. Gupta adds. .

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