Orbital floor fracture

Case contributed by Dr Bruno Di Muzio

Presentation

Unwitnessed fall at home. Left periorbital haematoma.

Patient Data

Age: 77
Gender: Female

Facial bones X-rays

Modality: X-ray

There is disruption of the inferior left orbital margin, irregularity of the lateral left orbital margin and opacification of the left maxillary sinus, consistent with fractures of the orbit.

No other fractures identified. The remaining paranasal sinuses and mastoid air cells are clear.​

CT Brain and Facial bones

Modality: CT

 

Left frontal pole intraparenchymal haemorrhage measures 1.7 x 1.0 cm with two further, smaller haemorrhagic foci in the right frontal lobe. Periventricular hypoattenuation in keeping with chronic small vessel ischaemic change. Incidental note of cavum septum pellucidum and cavum vergae. Ventricular size is age appropriate and unchanged. No midline shift.

Multiple bony fragments superior to the dens are well corticated and appear chronic. Left orbital floor fracture is depressed by 3.5 millimetres. No evidence of rectus muscle entrapment, retrobulbar haemorrhage or proptosis. Haemorrhage partially fills the left maxillary sinus. Left periorbital haematoma.

Conclusion: Bilateral frontal intraparenchymal haemorrhages. Left orbital floor fracture.

Case Discussion

Radiographs demonstrating a left orbit floor fracture and associated opacification of the maxillary sinus (hemosinus). These findings were confirmed on CT, which also demonstrated multiple small foci of brain haemorrhagic contusions

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Case Information

rID: 40580
Case created: 27th Oct 2015
Last edited: 27th Oct 2015
System: Head & Neck
Tag: rmh
Inclusion in quiz mode: Included

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