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A newborn baby girl was noted to have a facial mass at birth. Her mother did not know that she was pregnant until she was 4 months along, and did not receive regular prenatal care or take any vitamins during her pregnancy. 

On examination, the baby had a sac-like, fluid-filled mass on her face, located between the eyes and above her nose. The sac had a thin, almost transparent wall, and it was filled with fluid. The mass would get bigger when the baby cried, alarming her parents. The baby’s head was not enlarged and had a normal measurement. 

CT scan of the brain confirmed that the mass was a nasoethmoidal meningoencephalocoele (NEM). This means that there is a bony defect at the base of the skull, so that part of the brain and its covering slipped out through the defect and protruded out of the face. This abnormal development occurred while the baby was still in her mother’s womb. The CT scan also showed that there was no hydrocephalus (excess water in the brain). 

The baby underwent surgery for repair of the defect. The covering of the brain was repaired carefully to prevent leakage of fluid and possible infection. The excess tissue and thinned-out wall of the sac were removed so that the baby will have a normal appearance.

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