Presentation
Facial trauma followed by the onset of rapidly progressive right-sided facial cellulitis. CT to rule out a fracture or cavernous sinus thrombosis.
Patient Data
Right-sided parotid gland enlargement with diffuse fat stranding and hypertrophy of the right facial soft tissues.
Thickening of the cervical superficial fascia. No lymphadenopathy.
Focal dilatation of the left superior ophthalmic vein.
There is a similar dilatation in the right superior ophthalmic vein but seems collapsed / non-opacified.
Ping pong fracture sequelae.
Patency of the cavernous venous sinus and deep cerebral veins. No intracranial bleeding.
Case Discussion
This case demonstrates bilateral orbital varix, opacified on the left side but probably collapsed on the right side. Valsalva maneuver would have confirmed the diagnosis and demonstrated the increase in the size of the venous dilatations.
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