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Related Concept Videos

Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...

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Related Experiment Video

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Author Spotlight: Enhancing Visual Outcomes in Cataract Surgery: A Novel Technique to Prevent Posterior Capsular Opacification Through IOL Rotation
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Spontaneous Repositioning of a Traumatic Intraorbital Encephalocele.

Tanya Wolffenbuttel1, Nadine Denneman1, Sander Idema1

  • 1Department of Neurosurgery, Amsterdam University Medical Center.

The Journal of Craniofacial Surgery
|May 23, 2025
PubMed
Summary

Orbital roof fractures can cause rare traumatic intraorbital encephaloceles (TIOE). This case shows spontaneous TIOE reduction with conservative management as swelling subsided.

Keywords:
Neurotraumaorbital roof fracturesuperior orbital fissure syndrometraumatic intraorbital encephalocele

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Area of Science:

  • Neurosurgery
  • Oral and Maxillofacial Surgery
  • Ophthalmology

Background:

  • Orbital roof fractures are rare, high-energy trauma injuries often associated with intracranial damage.
  • Traumatic intraorbital encephalocele (TIOE) is a rare complication, involving brain tissue herniation into the orbit.
  • TIOE can compress vital intraorbital structures, including cranial nerves controlling eye movement.

Purpose of the Study:

  • To present a case of traumatic intraorbital encephalocele following orbital roof fracture.
  • To discuss the management and natural history of TIOE.
  • To highlight the potential for conservative management in select TIOE cases.

Main Methods:

  • Case report of a 23-year-old male with extensive facial fractures after a motor vehicle collision.
  • Observation of progressive left orbital roof displacement and TIOE development.
  • Conservative management with monitoring of intracranial swelling and orbital roof position.

Main Results:

  • A traumatic intraorbital encephalocele developed in the early post-trauma phase.
  • Spontaneous repositioning of the orbital roof and reduction of the TIOE occurred over several weeks.
  • Conservative management was successful as intracranial swelling subsided, followed by remodeling.

Conclusions:

  • Traumatic intraorbital encephalocele is a rare but serious complication of orbital roof fractures.
  • Conservative management may be effective for TIOE, particularly when associated with resolving intracranial swelling.
  • A multidisciplinary approach is crucial for managing TIOE and associated injuries.