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Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
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Traumatic orbital encephalocele: Presentation and imaging.
Leslie A Wei1, Tabassum A Kennedy2, Sean Paul3
1a Department of Ophthalmology, Oculoplastic, Facial Cosmetic and Orbital Surgery Service , University of Wisconsin - Madison , Madison , Wisconsin , USA.
Orbit (Amsterdam, Netherlands)
|February 25, 2016
Summary
Traumatic orbital encephalocele, a rare complication of orbital roof fractures, can be challenging to diagnose in children. Early recognition of an enlarging orbital mass on imaging is crucial for timely intervention.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatric Traumatology
Background:
- Traumatic orbital encephalocele is a rare but severe complication following orbital roof fractures.
- This condition can lead to significant morbidity, including vision loss.
Observation:
- This case series describes three pediatric patients who developed traumatic orbital encephalocele after significant head trauma.
- Mechanisms of injury included motor vehicle accidents and a self-inflicted gunshot wound.
- All patients presented with orbital roof fractures, frontal lobe contusions, and elevated intracranial pressure.
Findings:
- A key finding was the progression of proptosis and globe displacement 4 to 11 days post-injury.
- Initial CT scans revealed extraconal hemorrhage, which later enlarged, mimicking encephalocele.
- Diagnosis was confirmed by subsequent imaging, highlighting the difficulty in distinguishing encephalocele from hematoma on initial CT.
Implications:
- Orbital encephalocele is a sight-threatening condition requiring prompt diagnosis and management.
- High suspicion is warranted when imaging reveals an enlarging heterogeneous orbital mass associated with orbital roof fractures.
- MRI with contrast is recommended for definitive characterization when encephalocele is suspected.
