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Intraorbital meningocele

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

History of childhood head trauma, presented with left proptosis.

Patient Data

Age: 20 years
Gender: Female
mri

There is left frontal encephalomalacia area involving cortical and subcortical regions, appears hypointense in T1W and exhibits CSF signal( hyperintense in T2W and hypointense in FLAIR sequences), and shows no contrast enhancement in T1 post contrast, which herniated as CSF sac through bony defect in left orbital roof into orbit, extraconal, causing mass effect into left superior rectus complex muscles pushing them slightly inferolaterally.

Small area of white matter gliosis in the left frontal lobe (hyperintense in both T2W and FLAIR sequences) attract frontal horn of left lateral ventricle.

Case Discussion

MRI reveals sac filled with CSF into left orbit due to an osseous defect in orbital roof, likely post traumatic intraorbital meningocele.

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