Birth deformity. Baby girl who has been born with a congenital (present from birth) deformity of the brain. This is an encephalocele, where the skull has not formed properly and parts of the brain are found in a herniated sac bulging outside the head (upper left). The brain tissue found in the hernia is often abnormal, and the brain is often damaged. Most encepaloceles, like this one, are found extending from the rear of the head, and are called notencephaloceles. There is a risk that the hernia may burst. Surgical treatment is possible if only small amounts of the brain are displaced. Otherwise treatment is supportive, especially for any problems with vision. Photographed in Africa.