Case report: Surgical reconstruction of acrania in a preterm neonate in Nigeria

Abstract

Acrania is a rare, life-threatening congenital anomaly in which the flat bones in the cranial vault are either completely or partially absent, with complete but abnormal development of the cerebral hemispheres. In severe cases, surgical intervention is required for improved outcome. We present a 31-week gestational age, 1.6 kg female preterm neonate with acrania and no other associated congenital anomaly. On the eighth day of life, a scalp transpositional flap based on the superficial temporal and posterior auricular arteries was raised to cover the primary defect, and a split thickness skin graft was used to resurface the secondary defect. The patient did well postoperatively and was discharged to be monitored in the clinic. Early detection and multimodal specialist care is imperative for necessary intervention to prevent untoward complications.