Isolated orbital roof fracture with traumatic encephalocele

Several months after a fall down a flight of stairs, a one-year-old girl developed downward displacement and pulsation of the left eye. Vision and ocular motility were not impaired and the child remained neurologically normal. Computed tomography with metrizamide cisternography demonstrated herniation of brain tissue through a traumatic defect in the roof of the orbit. The orbital rim and other craniofacial bones were intact. Repair of the growing fracture found at operation restored normal appearance without disturbing function. To our knowledge, this is the first documented case of encephalocele associated with an isolated fracture of the orbital roof due to blunt head trauma.