Orbital blow-out and occipital condylar fracture

Case contributed by Louie Ye
Diagnosis certain

Presentation

Head injury

Patient Data

Age: 35 years
Gender: Male

A blowout fracture of the right orbit floor is associated with herniation of extra-occular fat into the maxillary sinus. The inferior rectus muscle is prolapsed slightly through the defect, however does not appear entrapped. A blowout fracture of the left orbit medial wall results in herniation of extra-occular fat into the ethmoid sinuses. The medial rectus muscle lies in the expected position.

Bilateral nasal bone fractures. No calvarial fracture. The mastoid air cells are clear.

A minimally displaced fracture of the basilar occiput extends from the foramen magnum to the left occipital condyle, and involves the articular surface. There is an associated fracture of the posterior aspect of the C1 left lateral mass, which extends to the margin of the transverse foramen.

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