Surgical Repair of an Occipital Meningocele in a Foal.
Authors: Alonso Juliana de M, Filho Pedro T H, Ávila Alice R, Machado Vânia M V, Hataka Alessandre, Bueno Lais M C, Alves Ana Liz G, Hussni Carlos A, Rodrigues Celso A, Watanabe Marcos J
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Surgical Repair of an Occipital Meningocele in a Foal Occipital meningoceles—herniation of meningeal tissue through a cranial bone defect—have never been previously documented in equine literature, making this case of a one-day-old Quarter Horse colt a significant clinical report. The foal presented with a mass in the occipital region and underwent surgical closure of the defect, which initially appeared successful; however, postoperative complications including infection, suspected hydrocephalus, and progressive neurological signs (ataxia, hypertonia, recumbency) emerged by day 13. Despite adjustments to antibiotic therapy and cerebrospinal fluid drainage, the colt deteriorated and was euthanised on postoperative day 14, with necropsy revealing bacterial encephalitis caused by multidrug-resistant *Escherichia coli* and ventricular dilation with gas accumulation. Whilst this case demonstrates that surgical closure of meningoceles is technically feasible in foals, it highlights a critical challenge: infectious complications—potentially seeded during initial injury or surgical repair—can rapidly progress to life-threatening encephalitis and may fundamentally limit long-term prognosis. Equine practitioners managing congenital cranial defects should consider aggressive perioperative antimicrobial protocols, anticipate the risk of secondary infection ascending to the central nervous system, and counsel clients on the guarded nature of such cases even when initial repair appears straightforward.
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Practical Takeaways
- •Occipital meningoceles are a possible congenital presentation in neonatal foals; surgical repair is technically possible but carries significant infection risk
- •Infectious complications, particularly multidrug-resistant bacterial infections, may severely limit long-term success even when surgical closure is achieved
- •Careful antibiotic selection, CSF monitoring, and early recognition of signs such as ataxia and hypertonia are critical for managing postoperative complications in meningocele repair cases
Key Findings
- •First reported case of cranial meningocele in horses, occurring in a 1-day-old Quarter Horse foal with an occipital mass
- •Surgical closure of the meningocele defect was technically feasible but complicated by postoperative infection
- •Bacterial encephalitis developed postoperatively, caused by multidrug-resistant E. coli, leading to hydrocephalus and neurological deterioration
- •Postmortem imaging revealed ventricular dilation with gas accumulation; foal was euthanized on postoperative day 14 due to lack of therapeutic response