• Jan-Oliver Neumann, Christian Herweh, and Marc-Eric Halatsch.
• Department of Neurosurgery, Universitätsklinikum Heidelberg, Heidelberg, Germany. Jan-Oliver.Neumann@med.uni-heidelberg.de
• Acta Neurochir (Wien). 2010 Apr 1; 152 (4): 713-6.

AbstractA newly-born infant with a congenital dural and bony defect and an associated short-segmented duplication of the superior sagittal sinus suffered from herniation and infarction of parietal brain tissue secondary to vacuum extraction. This ultimately led to the formation of a subgaleal cerebrospinal fluid (CSF) collection. Initial operative closure of the encephalocele was performed by attaching a galeal flap to the periostium surrounding the congenital defect. As the bony defect developed characteristics of a growing fracture later on, dural repair, transplantation of a split-bone flap and, finally, the insertion of a ventriculoperitoneal shunt became necessary. This case affirms that stringent indication and cautious usage of vacuum-assisted delivery is strongly recommended, especially in view of the possibility that undetected congenital cranial, vascular and/or cerebral alterations may be present.

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