title: Intraorbital encephalocele in an adult patient presenting with pulsatile exophthalmos. Case report.
abstract: A 25-year-old man presented with an intraorbital encephalocele manifesting as progressive left pulsatile exophthalmos. He had a history of frontal lobe contusion from a motorbike accident 10 years before the onset of the symptom. Computed tomography and magnetic resonance imaging revealed an oval-shaped defect in the left orbital roof with an underlying intracranial cystic lesion, herniated into the orbit. Intraoperative findings included disruption of the dura mater around the bony defect. The loculated arachnoid membrane and protruding brain tissue were excised with primary dural closure and reconstructive cranioplasty with a titanium mesh. The postoperative course was uneventful, and the pulsatile proptosis disappeared immediately after the procedure. Intracranial cyst may be important in the development of progressive pulsatile exophthalmos and intraorbital encephalocele.
authors.affiliation: Department of Neurosurgery, Ehime Prefectural South Uwa Hospital, Ehime, Japan. ANC51926@nifty.com
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Morihara
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Zenke
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shoda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suehiro
authors.forename: Takao
authors.initials: T
authors.lastname: Hatakeyama
mesh_terms: D000328:Adult; D020863:Central Nervous System Cysts / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D004677:Encephalocele / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005094:Exophthalmos / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005625:Frontal Lobe; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D009917:Orbital Fractures / Q000150:complications; D011673:Pulsatile Flow; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome