J Korean Neurosurg Soc.  2015 Jan;57(1):58-60. 10.3340/jkns.2015.57.1.58.

Intraorbital Encephalocele Presenting with Exophthalmos and Orbital Dystopia : CT and MRI Findings

• Asil K
• Gunduz Y
• Yaldiz C
• Aksoy YE

• KMID: 2067093
• DOI: http://doi.org/10.3340/jkns.2015.57.1.58

Abstract

A 15-year-old female patient with progressive pulsatile exophthalmos caused by intraorbital encephalocele was evaluated with computed tomography (CT) and magnetic resonance imaging (MRI) in our clinic. She had no history of trauma or reconstructive surgery. When she was a little girl, she had undergone surgery for congenital glaucoma on the right eye. On the three-dimensional image of CT, a hypoplasic bone defect was observed in the greater wing of the right sphenoid bone. MRI and CT scan showed herniation through this defect of the arachnoid membrane and protruded cerebral tissue into the right orbita. Intraorbital encephalocele is an important entity that can cause pulsatile exophthalmos and blindness.

Keyword

Intraorbital encephalocele; 3-dimensional CT; MRI

MeSH Terms

Adolescent
Arachnoid
Blindness
Encephalocele*
Exophthalmos*
Female
Glaucoma
Humans
Imaging, Three-Dimensional
Magnetic Resonance Imaging*
Membranes
Orbit*
Sphenoid Bone
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Skin reformatted three-dimensional CT scan of the patient showing exophthalmos and dystopia in the right eye and increased distance between the eyeballs due to dystopia.

• 

  Fig. 2 Bone-reformatted three-dimensional CT scan of the patient showing enlargement of the right orbital cavity and large bone defect in the superior orbital fissure secondary to hypoplasia. The bone defect allows the petrous part of the temporal bone to be viewed in the posterior plain (arrows). The normal superior orbital fissure in the left orbita is shown with arrows.

• 

  Fig. 3 T2-weighted coronal MRI showing the inferio-lateral displacement of the right bulbus oculi. The right bulbus oculi is markedly larger than the left bulbus oculi.

• 

  Fig. 4 A : The T1-weighted sagittal MRI without contrast demonstrating a large bone defect and cerebral tissue within the defect protruding into the orbita. B : The T2-weighted sagittal MRI demonstrating no apparent dysplasia in cerebral tissue, but an increase in the levels of peripheral cerebrospinal fluid and marked exophthalmos and displacement toward the anterior of the right bulbus oculi.

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