Late Surgical Management Of A Rare Case Of Post-traumatic Orbital Encephalocele

Keywords: Orbital encephalocele, Traumatic encephalocele

Abstract

Orbital roof fractures after blunt head trauma are not uncommon. Hernia ion of the brain tissues into the orbit through a bony defect, so-called post-traumatic orbital encephalocele, is a rare entity. The herniated braint issue causes compression of the intraorbital contents, particularly the optic nerve, extraocular nerves and muscles and compromise the vascular supply. Raisedintraorbital pressure may lead to irreversible damage to the optic nerve. This can be prevented by early diagnosis and timely management. Repair of the orbital roof needs to be performed to avoid transmission of intracranial pressure into the orbit. Early intervention is needed in order to prevent visual loss. We present a case of posttraumatic orbital encephalocele who underwent latesurgical treatment with direct repair of dura opening, reinforcement with temporalis fascia and reconstruction of orbital roof using skull bone graft. Complete resolution of the pulsatile proptosis with excellent cosmetic result was observed at follow up. However, the visual diminution did not recover significantly due to late diagnosis and intervention. Early diagnosis and surgical management of this rare condition can prevent permanent visual loss and also achieve good cosmetic results.

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Author Biographies

Yugal Jyoty Nepal, General Surgery Patan Academy of Health Sciences Patan

Resident

Sushil Krishna Shilpakar, Department of Neurosurgery Tribhuwan University Teaching Hospital Kathmandu

Professor

Gopal Sedain, Department of Neurosurgery Tribhuwan University Teaching Hospital Kathmandu

Assistant Professor

Dipendra Kumar Shrestha, Department of Neurosurgery Tribhuwan University Teaching Hospital Kathmandu

MCh Resident

Published
2019-12-31
How to Cite
Nepal, Y., Shilpakar, S., Sedain, G., & Shrestha, D. (2019). Late Surgical Management Of A Rare Case Of Post-traumatic Orbital Encephalocele. Nepal Journal of Neuroscience, 16(3), 76-79. https://doi.org/10.3126/njn.v16i3.27366
Section
Case Report