DOI: https://doi.org/10.36347/sasjs.2025.v11i04.007

Pages: 442-447

Intra-orbital meningoencephalocele (MEC) is a rare condition involving the herniation of brain tissue and meninges into the orbital cavity, typically associated with congenital anomalies, tumors, or trauma. Its occurrence during pregnancy is exceptionally uncommon and presents unique diagnostic and therapeutic challenges due to physiological changes and the dual imperative to protect maternal and fetal well-being. We report the first documented case of a pregnant woman with post-traumatic intra-orbital MEC. A 24-year-old woman at 12 weeks’ gestation presented with polytrauma following a fall, manifesting with significant right periorbital swelling, exophthalmos, and visual impairment. Radiological evaluation revealed extensive craniofacial trauma, including a right orbital roof fracture with frontal lobe herniation into the orbit. Obstetric assessment confirmed fetal viability. A multidisciplinary team coordinated a staged management plan prioritizing both maternal stabilization and fetal safety. Neurosurgical intervention via frontal craniotomy enabled the excision of herniated brain tissue, dural closure, and orbital roof reconstruction. This was followed by orthopedic fixation of a femoral shaft fracture. The anesthetic management was adapted to minimize fetal exposure while ensuring maternal stability. Postoperative recovery was uneventful, with preserved vision and neurological function. Follow-up imaging confirmed successful reconstruction, and obstetric monitoring showed normal fetal development. This case underscores the feasibility and importance of timely surgical management of complex cranial pathologies during early pregnancy. It highlights the critical role of multidisciplinary coordination, individualized anesthetic planning, and the value of imaging in guiding surgical decision-making. Despite the high-risk context, both maternal and fetal outcomes were favorable, reinforcing that carefully tailored interventions can yield excellent results even in ra