Orbitofrontal Extradural Hematoma: Unusual Cause of Proptosis

2021 ◽  
pp. 1-4
Author(s):  
Akshay V. Kulkarni ◽  
Tejesh Mishra ◽  
B. Indira Devi ◽  
Dhananjaya I. Bhat ◽  
Subhas Konar ◽  
...  
Keyword(s):  
Head Injury ◽  
Clinical Presentation ◽  
Extradural Hematoma ◽  
Case Presentation ◽  
Orbital Roof ◽  
Surgical Evacuation ◽  
Orbital Hematoma ◽  
Orbital Roof Fractures

<b><i>Introduction:</i></b> Frontal extradural hematoma (EDH) extending into orbit is an uncommon entity. Clinical presentation can be subacutely progressive proptosis following head injury. <b><i>Case Presentation:</i></b> We present a case of frontal EDH with orbital extension which had delayed progressive proptosis. The patient improved clinically after surgical evacuation of EDH. <b><i>Conclusion:</i></b> It is important to look for orbital roof fractures, orbital hematoma in cases of head injury. Such cases should be treated surgically at the earliest.

scholarly journals Factors Affecting the Surgical Outcome in Extradural Hematoma in Punjab Institute of Neurosciences, Lahore, Pakistan

2017 ◽  
Vol 14 (3) ◽  
pp. 13-18 ◽  
Author(s):  
Azam Niaz ◽  
Muhammad Hammad Nasir ◽  
Kiran Niraula ◽  
Sumra Majeed ◽  
Joshan Neupane ◽  
...  
Keyword(s):  
Head Injury ◽  
Surgical Outcome ◽  
Cross Sectional Study ◽  
P Value ◽  
Affecting Factors ◽  
Extradural Hematoma ◽  
Hematoma Volume ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Surgical Evacuation

Head injury is a leading cause of death in young age group. Extra Dural hematoma, a complication of head injury, is often fatal if not treated in time. The surgical outcome of EDH is dependent upon many variables including preoperative GCS, time between injury and surgery, associated intracranial injuries, anisocoria and hematoma volume. In order to reduce the mortality near to nil, it is essential to determine the magnitude of effect of affecting factors on surgical outcome which will also help us in preoperative counseling and prioritizing the operative candidates. This study was conducted determine the factors affecting surgical outcome of traumatic intracranial extradural Hematoma in Punjab Institute of Neurosciences/ Lahore general hospital, Lahore. It was a Cross sectional study conducted for 3 years from 28th May 2012 to 28th May 2015.The study was conducted on the patients admitted through emergency and diagnosed as Extramural hematoma. These patients underwent surgical evacuation of EDH on emergent basis and outcome was measured by Glasgow Outcome Scale (GOS) after 48 hours of surgery. Using GOS, good surgical outcome was observed in 80.9% (157 out of 194) patients. Preoperative GCS, anisocoria, hematoma volume, associated intracranial injuries and time between injury and surgery were the factors affecting the outcome significantly (p value=0.000) while age and sex of the patient had no significant effect. In Conclusion, good surgical outcome is associated with patients with solitary Extra Dural Hematoma of volume less than 60 ml, preoperative GCS more than 8, absence of anisocoria and undergoing surgical evacuation within 6 hours of injury. Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, Page: 13-18

scholarly journals Transorbital Craniocerebral Occult Penetrating Injury with Cerebral Abscess Complication

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Arif Abdulbaki ◽  
Faisal Al-Otaibi ◽  
Amal Almalki ◽  
Nasser Alohaly ◽  
Saleh Baeesa
Keyword(s):  
Head Injury ◽  
Frontal Lobe ◽  
Clinical Presentation ◽  
Penetrating Injury ◽  
Cerebral Abscess ◽  
Initial Presentation ◽  
Mechanism Of Injury ◽  
Review Of The Literature ◽  
Orbital Roof ◽  
Cerebral Infection

Transorbital intracranial penetrating injury is an uncommon mechanism of head injury. These injuries can be occult during the initial clinical presentation. Certain patients develop an intracranial cerebral infection. Herein, we report a 5-year-old child with an occult transorbital intracranial penetrating injury caused by a pen. A retained pen tip was found at the superior orbital roof and was not noticed at initial presentation. This was complicated by a right frontal lobe cerebral abscess. This paper emphasizes the importance of orbitocranial imaging in any penetrating orbital injury. A review of the literature on intracranial infection locations in relation to the route and mechanism of injury is included to complement this report.

scholarly journals TRAUMATIC EXTRADURAL HEMATOMA

2014 ◽  
Vol 21 (03) ◽  
pp. 540-543
Author(s):  
Mian Iftikhar ul Haq
Keyword(s):  
Head Injury ◽  
Clinical Presentation ◽  
Head Injuries ◽  
Bleeding Disorders ◽  
Parietal Region ◽  
Extradural Hematoma ◽  
Cross Sectional ◽  
Gcs Score ◽  
Age Range ◽  
Study Setting

Objectives: To determine the frequency, clinical presentation and outcome ofextradural hematoma in patients with head injury. Study Design: Cross sectional descriptivest study. Setting: Neurosurgery department of Hayatabad Medical Complex, Peshawar. Period: 1st January 2011 to 1 July 2012. Patients and methods: All patients of head injury, from all ages andboth genders were included. Patients in whom EDH caused by bleeding disorders or vascularmalformations of the dura mater and post surgical EDHs were excluded from the study. CT scanbrain was done for all patients to confirm their diagnosis. The information regarding patientdemographical details, clinical presentation and site and size of hematoma was documented inpatient's Performa. The data was analyzed by SPSS version 16. Results: A total of 331 patientswith head injuries were included in the study. Out of 331 patients, there were 221(66.76%) malesand 110(33.23%) females. Majority of patients 90(27.2%) were in the age range of 21-30 years.EDH was found in 29(8.76%) patients. The commonest location of extradural hematoma wastemporo-parietal region i.e 3.93%. One patient had left side weakness postoperatively andtwo(6.89%) died. Conclusions: The outcome of operated extradural hematoma patients wasgood in those patients having higher GCS score

Nonoperative Management of Extradural Hematoma

Neurosurgery ◽  
1985 ◽  
Vol 16 (5) ◽  
pp. 602-606 ◽  
Author(s):  
R. Bullock ◽  
R.M. Smith ◽  
J.R. van Dellen
Keyword(s):  
Head Injury ◽  
Conservative Treatment ◽  
Nonoperative Management ◽  
Ct Scanning ◽  
Extradural Hematoma ◽  
Computed Tomographic ◽  
Neurological Signs ◽  
Nonsurgical Management ◽  
Surgical Evacuation ◽  
Serial Ct

Abstract Extradural hematomas (EDHs) do not always require surgical evacuation. We report a subgroup of conscious patients harboring EDHs who were referred for computed tomographic (CT) scanning several days after head injury with neurological signs that were static or improving. Twelve patients with EDHs 12 to 38 ml in volume were offered nonsurgical management and were followed by serial CT scanning. All patients made a complete neurological recovery and showed resolution of the hematoma on CT scanning over a period of 3 to 15 weeks. The features that may make an extradural hematoma suitable for conservative treatment are discussed.

scholarly journals Traumatic Intracranial Frontal Extradural Hematoma Associated with Orbital Subperiosteal Hematoma

2012 ◽  
Vol 1 (1) ◽  
pp. 52-53
Author(s):  
MK Gupta ◽  
K Dhungel ◽  
PL Sah ◽  
K Ahmad ◽  
RK Rauniyar
Keyword(s):  
Head Injury ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Rare Event ◽  
Simultaneous Occurrence ◽  
Extradural Hematoma ◽  
Subconjunctival Hemorrhage ◽  
Clinical Recovery ◽  
Surgical Evacuation

Intracranial extradural hematoma (EDH) is a frequent lesion but simultaneous occurrence of EDH with orbital subperiosteal hematoma following head injury is a rare event. We report a 22 year old male who sustained head injury during road traffic accident. Glasgow coma scale was 13/15 on arrival and he had left orbital ecchymosis & subconjunctival hemorrhage. CT revealed left frontal extradural hematoma with associated orbital subperiosteal hematoma. No bone fracture was seen. The patient had good clinical recovery following surgical evacuation of the hematomas.DOI: http://dx.doi.org/10.3126/njr.v1i1.6325 Nepalese Journal of Radiology Vol.1(1): 52-53 

scholarly journals Posttraumatic Subperiosteal Orbital Hematoma With Intracranial Hemorrhage in A Male Infant

2021 ◽  
Author(s):  
Yeon Jeong Lee ◽  
Yungju Yoo
Keyword(s):  
Intracerebral Hemorrhage ◽  
Male Infant ◽  
Surgical Removal ◽  
Intermittent Exotropia ◽  
Case Presentation ◽  
Orbital Roof ◽  
Acute Intracerebral Hemorrhage ◽  
Unilateral Proptosis ◽  
Orbital Hematoma ◽  
Work Up

Abstract Background: To the best of our knowledge, there has been no report of subperiosteal orbital hematoma combined with intracerebral hemorrhage in pediatric patients.Case presentation: A healthy 9-month-old boy with left superior tarsal conjunctival prolapse was admitted to the emergency room after left periorbital blunt trauma. Computer tomography of the brain showed a left orbital roof fracture and subperiosteal orbital hematoma with acute intracerebral hemorrhage. He received emergency craniotomy. Three days after the craniotomy, the subperiosteal hematoma and proptosis increased. An anterior orbitotomy with orbital subperiosteal hematoma evacuation and drain placement were performed. Nine months after surgery, the left blepharoptosis and conjunctival prolapse improved and fix and follow were good in his both eyes. However, a new-onset intermittent exotropia and left hypotropia were detected. Conclusions: Orbital subperiosteal hematoma must be considered in the differential diagnosis of acute unilateral proptosis after trauma. In infants and children, a thorough work-up to detect concomitant intracerebral hemorrhage is necessary. Prompt surgical removal of hematoma is recommended to prevent complications

scholarly journals Reconstruction of a Combined Frontal Bone and Orbital Roof Defect With Associated Meningoencephalocele Using 3D Modeling and 3D Navigation

2021 ◽  
Vol 6 ◽  
pp. 247275122110233
Author(s):  
Rory C. O’Connor ◽  
Sead Abazi ◽  
Jehuda Soleman ◽  
Florian M. Thieringer
Keyword(s):  
3D Modeling ◽  
Road Traffic ◽  
Treatment Algorithm ◽  
Visual Disturbance ◽  
High Energy ◽  
Frontal Bone ◽  
3D Navigation ◽  
Orbital Roof ◽  
Close Observation ◽  
Orbital Roof Fractures

Introduction: Orbital roof fractures are uncommon and normally associated with high energy trauma in which multiple other injuries are present. Most can be managed non-operatively with close observation. However, in a small proportion the defect is such that it permits the development of a meningoencephalocele, which can cause exophthalmos, a reduction in visual acuity and pain, all of which are unlikely to improve without surgical treatment. In light of their scarcity and the potential of serious risks with surgery that includes meningitis and visual disturbance (or even loss), thorough planning is required so that the meningoencephalocele can be reduced safely and the orbital roof adequately reconstructed. Methods: We report a case of a patient with a frontal bone defect, orbital roof fracture and associated meningoencephalocele that presented years after being involved in a road traffic accident in another country, who complained of a significant headache and orbital pain. The use of 3D modeling to help plan the surgery, and intraoperative 3D navigation to help negotiate the anterior skull base are described along with the reconstruction of the frontal bone and orbital roof using titanium mesh contoured on the 3D model. Conclusions: Although conservative management of orbital roof fractures predominates; those that are symptomatic, have associated neurologic symptoms or pose a risk to the eyesight warrant a surgical approach. The methods of repair, which center around separating the intracranial and intraorbital contents, are described in the context of this patient and previous cases, and a treatment algorithm is proposed.

Orbital Roof Fractures in the Pediatric Population

1989 ◽  
Vol 84 (2) ◽  
pp. 213-216 ◽  
Author(s):  
Alan Messinger ◽  
Mary Ann Radkowski ◽  
Mark J. Greenwald ◽  
Jay M. Pensler
Keyword(s):  
Pediatric Population ◽  
Orbital Roof ◽  
Orbital Roof Fractures

Pediatric Orbital Roof Fractures: A Ratio of Orbital Dimensions Correlated to Prevalence of Fracture

2020 ◽  
Author(s):  
Stephen C. Dryden ◽  
Andrew G. Meador ◽  
Andrew B. Johnston ◽  
Adrianna E. Eder ◽  
James C. Fleming ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Pediatric Population ◽  
Relative Length ◽  
Orbital Floor ◽  
Orbital Fracture ◽  
Orbital Roof ◽  
Fracture Patterns ◽  
Gender And Age ◽  
The Mean ◽  
Orbital Roof Fractures

Abstract Objective Orbital roof fractures are more likely to occur in younger children, specifically younger than 7 years. Cranium to face ratio decreases with age; however, there is no definition for measurement of the neurocranium or face. We propose using the length of the orbital roof as a measurement of the neurocranium and length of the orbital floor as a tool to estimate midface size. The purpose of this study is to test this measurement as a correlation rate of orbital roof fractures within the pediatric population. Design This is a retrospective study. Setting This study was done at the LeBonheur Children's Hospital. Participants Sixty-six patients with orbital roof fractures were identified and stratified by gender and age, specifically younger than 7 years and 7 years or older. Main Outcome Measures The main outcome measures were orbital roof length, floor length, and ratio thereof. Results Mean orbital roof length was 43.4 ± 3.06 and 45.1 ± 3.94 mm for patients <7 and ≥7 years, respectively (p = 0.02). Mean orbital floor length was 41.3 ± 2.99 and 47.7 ± 4.19 for patients <7 and ≥7 years, respectively (p < 0.00001). The mean roof to floor ratio (RTFR) for patients <7 years was 1.051 ± 0.039 and for patients ≥ 7 years was 0.947 ± 0.031 (p < 0.00001). Conclusion As children age, the relative length of the orbital roof decreases when compared with the orbital floor. The RTFR was more than 1.0 in children younger than 7 years. These differences were statistically significant when compared with children 7 years and older. This measurement shift follows the differences noted in orbital fracture patterns during childhood.

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