SURGICAL MANAGEMENT OF CRANIUM BIFIDUM WITH MENINGOCELE IN A JERSEY CALF UNDER RESOURCE-LIMITED SETTINGS: A RETROSPECTIVE CASE REPORT

Abstract

ABSTRACT: Cranium bifidum is a congenital defect that develops due to the failure of neural tube closure during fetal development. This results in the development of an osseous defect in the calvaria, through which herniation of meninges and cranial structures occurs. The congenital defect in a four-day-old male Jersey calf suffering from large fluctuating swelling over the parieto-occipital region was reported to Regional Veterinary Hospital & Epidemiology Center, Dewathang from Gomdhar Gewog under Samdrup Jongkhar Dzongkhag. Upon close examination, the calf was recumbent and exhibited rapid abdominal respiration. The swelling was warm, fluctuating, and pedunculated. Preemptively, a fine-needle aspiration was performed and serosanguinous fluid was observed. The fluid inside the swelling was drained and the skin flap produced was then excised completely. The hernial ring-like opening at the base was closed initially with absorbable suture material; PGA Sterile (2-0), followed by in-layers with same suture material and size. The skin was apposed using a horizontal-mattress pattern using silk suture. Then the calf was treated with antibiotic (Injection Cefotaxime) and analgesic (Injection Meloxicam) post-surgery along with daily antiseptic dressing of the surgical wound. The prognosis was grave due to the involvement of neurological structures, which required specialized surgical intervention, and unfortunately, the patient did not recover uneventfully. The condition was diagnosed retrospectively as Cranium Bifidum with Meningocele, and this unique case highlights the diverse range of clinical conditions encountered in the field and underscores the need for in-depth knowledge in diagnosing and managing such condition within resource-limited veterinary settings, such as certain remote places in Bhutan.