{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T14:16:27Z","timestamp":1769264187389,"version":"3.49.0"},"reference-count":28,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Aplasia cutis congenita (ACC) is a rare congenital condition marked by the absence of skin layers and sometimes underlying structures. Its etiology is unclear, with up to 70% of cases involving the scalp. We report the first document case of ACC in Ghana.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n A 1-day-old female, born through spontaneous vaginal delivery after an uneventful pregnancy, was referred for management of a scalp defect noted at birth. Examination revealed an 8 \u00d7 5.5 cm central scalp defect with absent cranial vault, partial fronto-parietal bone loss, dural defect, exposed arachnoid membranes, and visible superior sagittal sinus. Other physical findings were normal. Brain magnetic resonance imaging (MRI), whole-body MRI, and echocardiography were unremarkable. A brain computed tomography confirmed a skull defect. The patient underwent a duraplasty using bovine pericardium and received serial wound dressings with epithelial growth factors. The defect reduced to 4.5 \u00d7 3.6 cm post-surgery and continues to improve pending potential cranioplasty at 2 years. ACC is primarily diagnosed clinically, and this patient was diagnosed with type 1 ACC. Management depends on subtype, location, defect size, and infection risk. In this case, surgery was employed due to the size of defect and the risk it posed. Prognosis is generally favorable, but limited resources may delay and increase complications in low-income settings.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n ACC with skull and dural involvement poses serious risks to infant survival in resource-limited settings, where systemic challenges are pervasive. This case highlights the importance of care that is locally adapted, affordable, and delivered through strong multidisciplinary collaboration.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1245_2025","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:58:10Z","timestamp":1769151490000},"page":"46","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of aplasia cutis congenita of the scalp and skull defect in a resource-limited setting: A case report"],"prefix":"10.25259","volume":"17","author":[{"given":"Ruth","family":"Agyekum","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwadwo","family":"Darko","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Korle Bu Teaching Hospital, Accra, Axim, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana Yaa Amoakosah","family":"Odame","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital, Legon, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliza Akosua Asaa","family":"Gyebi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Axim Government Hospital, Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelyn Anna","family":"Haizel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Ghanuba Specialist Hospital, Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicia Naa Adjorkor","family":"Kpoh","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Greater Accra Regional Hospital, Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Al-Hassan Dasana","family":"Andani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Greater Accra Regional Hospital, Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"10.25259\/SNI_1245_2025\/ref-1","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1054\/bjps.2002.3915","article-title":"Management of aplasia cutis congenita in a non-scalp location","volume":"55","author":"Ahan","year":"2002","journal-title":"Br J Plast Surg"},{"key":"10.25259\/SNI_1245_2025\/ref-2","doi-asserted-by":"crossref","first-page":"bcr1020114965","DOI":"10.1136\/bcr.10.2011.4965","article-title":"Two different management modalities in a two sibling case report of Adams Oliver syndrome","volume":"2011","author":"Al-Hadithy","year":"2011","journal-title":"BMJ Case Rep"},{"key":"10.25259\/SNI_1245_2025\/ref-3","doi-asserted-by":"crossref","first-page":"319","DOI":"10.5455\/medarh.2023.77.319-322","article-title":"Aplasia cutis congenita of the scalp with bone defect and exposed sagittal sinus in trisomy 13 newborn-a case report","volume":"77","author":"AlMatrif","year":"2023","journal-title":"Med Arch"},{"key":"10.25259\/SNI_1245_2025\/ref-4","first-page":"103496","article-title":"Congenital cutaneous aplasia of the limbs: A case report","volume":"76","author":"Amaaoune","year":"2022","journal-title":"Ann Med Surg (Lond)"},{"key":"10.25259\/SNI_1245_2025\/ref-5","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1097\/00006123-199610000-00025","article-title":"Bovine pericardium for Dural grafts: Clinical results in 35 patients","volume":"39","author":"Anson","year":"1996","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1245_2025\/ref-6","doi-asserted-by":"crossref","first-page":"166","DOI":"10.4103\/ijpd.IJPD_93_18","article-title":"Aplasia cutis congenita of the scalp: The success of conservative approach in treatment of a large defect","volume":"20","author":"Barcot","year":"2019","journal-title":"Indian J Paediatr Dermatol"},{"key":"10.25259\/SNI_1245_2025\/ref-7","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1097\/01.scs.0000246500.84935.4f","article-title":"Aplasia cutis congenita of the scalp and calvarium: Conservative wound management with novel wound dressing materials","volume":"18","author":"Basterzi","year":"2007","journal-title":"J Craniofac Surg"},{"key":"10.25259\/SNI_1245_2025\/ref-8","doi-asserted-by":"crossref","first-page":"273","DOI":"10.4103\/sni.sni_188_17","article-title":"Aplasia cutis congenita: Two case reports and discussion of the literature","volume":"8","author":"Blionas","year":"2017","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_1245_2025\/ref-9","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s00381-023-06190-x","article-title":"Large aplasia cutis congenita of the vertex conservative management","volume":"40","author":"Bouali","year":"2023","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_1245_2025\/ref-10","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/jdv.18690","article-title":"Epidemiology of aplasia cutis congenita: A population-based study in Europe","volume":"37","author":"Coi","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.25259\/SNI_1245_2025\/ref-11","first-page":"556","article-title":"Extrait d\u2019une letter au sujet de trios enfants de la meme mere nes avec partie des extremites denuee de peau","volume":"26","author":"Cordon","year":"1767","journal-title":"J Med Chir Pharm"},{"key":"10.25259\/SNI_1245_2025\/ref-12","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/PL00012392","article-title":"Bovine pericardium for duraplasty: Clinical results in 32 patients","volume":"24","author":"Filippi","year":"2001","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI_1245_2025\/ref-13","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/S0190-9622(86)70082-0","article-title":"Aplasia cutis congenita: A clinical review and proposal for classification","volume":"14","author":"Frieden","year":"1986","journal-title":"J Am Acad Dermatol"},{"key":"10.25259\/SNI_1245_2025\/ref-14","doi-asserted-by":"crossref","first-page":"e220","DOI":"10.1055\/s-0034-1387195","article-title":"Conservative healing of an 11 \u00d7 9-cm aplasia cutis congenita of the scalp with bone defect","volume":"75","author":"Fr\u00f6jd","year":"2014","journal-title":"J Neurol Surg Rep"},{"key":"10.25259\/SNI_1245_2025\/ref-15","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.ciresp.2023.01.012","article-title":"Evaluation of the usefulness of the Clavien-Dindo classification of surgical complications","volume":"101","author":"Golder","year":"2023","journal-title":"Cir Esp (Engl Ed)"},{"key":"10.25259\/SNI_1245_2025\/ref-16","first-page":"100079","article-title":"Revised surgical CAse REport (SCARE) guideline: An update for the age of artificial intelligence","volume":"10","author":"Kerwan","year":"2025","journal-title":"Prem J Sci"},{"key":"10.25259\/SNI_1245_2025\/ref-17","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1097\/SCS.0000000000005874","article-title":"An aplasia cutis congenita: Suggestion of management algorithm","volume":"30","author":"Lee","year":"2019","journal-title":"J Craniofac Surg"},{"key":"10.25259\/SNI_1245_2025\/ref-18","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1159\/000490786","article-title":"Aplasia cutis congenita: A case report","volume":"10","author":"Magliah","year":"2018","journal-title":"Case Rep Dermatol"},{"key":"10.25259\/SNI_1245_2025\/ref-19","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.ijgo.2014.11.029","article-title":"Aplasia cutis congenita presenting as vacuum-extractor-related trauma","volume":"129","author":"Marcovici","year":"2015","journal-title":"Int J Gynaecol Obstet"},{"key":"10.25259\/SNI_1245_2025\/ref-20","first-page":"291","article-title":"Aplasia cutis congenita: A report of two cases from National Hospital Abuja, Nigeria and review of the literature","volume":"36","author":"Mukhtar-Yola","year":"2020","journal-title":"Pan Afr Med J"},{"key":"10.25259\/SNI_1245_2025\/ref-21","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1055\/s-0041-1735560","article-title":"Cranioplasty","volume":"37","author":"Ong","year":"2021","journal-title":"Facial Plast Surg"},{"key":"10.25259\/SNI_1245_2025\/ref-22","doi-asserted-by":"crossref","first-page":"e154","DOI":"10.1097\/SCS.0000000000003347","article-title":"Conservative treatment of large aplasia cutis congenita of the scalp with bone defect with basic fibroblast growth factor application","volume":"28","author":"Orgun","year":"2017","journal-title":"J Craniofac Surg"},{"key":"10.25259\/SNI_1245_2025\/ref-23","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.wneu.2018.08.024","article-title":"Effect of Dural substitute and technique on cranioplasty operative metrics: A systematic literature review","volume":"119","author":"Raghavan","year":"2018","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_1245_2025\/ref-24","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1007\/s00381-006-0074-y","article-title":"Aplasia cutis congenita of the scalp: Is there a better treatment strategy?","volume":"22","author":"Santos De Oliveira","year":"2006","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_1245_2025\/ref-25","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1159\/000512022","article-title":"A case of large aplasia cutis congenita with underlying skull defect: Effective surgical treatment with Integra\u00ae dermal regeneration template","volume":"56","author":"Scotti","year":"2021","journal-title":"Pediatr Neurosurg"},{"key":"10.25259\/SNI_1245_2025\/ref-26","first-page":"e7047","article-title":"Treatment of a large skull defect and brain herniation in a newborn with Adams-Oliver syndrome","volume":"12","author":"Wehrens","year":"2020","journal-title":"Cureus"},{"key":"10.25259\/SNI_1245_2025\/ref-27","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1097\/00006534-199012000-00003","article-title":"Conservative treatment of cutis aplasia","volume":"86","author":"Wexler","year":"1990","journal-title":"Plast Reconstr Surg"},{"key":"10.25259\/SNI_1245_2025\/ref-28","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1002\/ccr3.611","article-title":"Failed conservative management of a case of aplasia cutis congenita in a low-income country","volume":"4","author":"Wingi","year":"2016","journal-title":"Clin Case Rep"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/surgical-management-of-aplasia-cutis-congenita-of-the-scalp-and-skull-defect-in-a-resource-limited-setting-a-case-report\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/surgical-management-of-aplasia-cutis-congenita-of-the-scalp-and-skull-defect-in-a-resource-limited-setting-a-case-report\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:58:21Z","timestamp":1769151501000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/surgical-management-of-aplasia-cutis-congenita-of-the-scalp-and-skull-defect-in-a-resource-limited-setting-a-case-report\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":28,"alternative-id":["10.25259\/SNI_1245_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_1245_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1,23]]},"article-number":"46"}}