# A Pathophysiological Approach to Spontaneous Orbital Meningoceles: Case Report and Systematic Review

## TL;DR

This paper reports a rare case of an orbital meningocele in a child and reviews existing literature to emphasize the importance of understanding its pathophysiology for treatment.

## Contribution

The study presents a new clinical case and provides a systematic review of spontaneous orbital meningoceles, highlighting treatment approaches and pathophysiological insights.

## Key findings

- A 6-year-old patient with orbital meningocele showed clinical improvement after endovascular thrombectomy and stenting.
- The systematic review found that surgery is the most common treatment for spontaneous orbital meningoceles.
- The paper emphasizes the need for further data collection due to the limited number of reported cases.

## Abstract

Background: Spontaneous orbital cephaloceles are a rare condition. The purpose of this study is to provide a description of a clinical case and to carry out a systematic literature review. Methods: A systematic review of the English literature published on the Pubmed, Scopus, and Web of Science databases was conducted, according to the PRISMA recommendations. Results: A 6-year-old patient was admitted for right otomastoiditis and thrombosis of the sigmoid and transverse sinuses, as well as the proximal portion of the internal jugular vein. Radiological examinations revealed a left orbital mass (22 × 14 mm) compatible with asymptomatic orbital meningocele (MC) herniated from the superior orbital fissure (SOF). The child underwent a right mastoidectomy. After the development of symptoms and signs of intracranial hypertension (ICH), endovascular thrombectomy and transverse sinus stenting were performed, with improvement of the clinical conditions and reduction of the orbital MC. The systematic literature review encompassed 29 publications on 43 patients with spontaneous orbital MC. In the majority of cases, surgery was the preferred treatment. Conclusions: The present case report and systematic review highlight the importance of ICH investigation and a pathophysiological-oriented treatment approach. The experiences described in the literature are limited, making the collection of additional data paramount.