Management of encephaloceles and craniofacial problems in the neonatal period.

Although craniofacial problems are commonly detected during the neonatal period, only a selected subgroup of lesions require early intervention. Such lesions are characterized either by their potential for causing early neurologic impairment, infection, or other severe sequelae if treatment is delayed or by the fact that the therapeutic outcome is more favorable with early intervention. An overriding consideration in the decision to treat any of these problems during the neonatal period is the risk of major blood loss, which can pose a life-threatening problem. Accordingly, meticulous surgical technique and close monitoring of hemodynamic status are crucial to optimizing therapeutic outcome. Herein, we present therapeutic caveats and operative techniques for the neurosurgical management of craniofacial lesions commonly encountered during the neonatal period.