Frontal epidural haematoma with ipsilateral exophthalmos

✍ Scribed by B. Bollinger; L. Lomholdt Knudsen

• Book ID: 104779133
• Publisher: Springer
• Year: 1987
• Tongue: English
• Weight: 97 KB
• Volume: 29
• Category: Article
• ISSN: 0028-3940
• DOI: 10.1007/bf00451781

✦ Synopsis

Case report Discussion

A 20-year-old man was hit with a bottle in the left frontotemporal region. No loss of consciousness. After suture of a 7 cm long wound in the local hospital, the patient became increasingly drowsy and developed progressive left-sided exophthalmos, chemosis and reduced vision. One week later he was transferred to an ophthalmological department, awake and alert but with unchanged severe symptoms from the left eye. Radiographs of the skull showed multiple fractures in the left temporal region. CT scan of the brain and orbit demonstrated a large epidural haematoma in the left frontal region with a maximal width of 4 cm (Fig. 1 a), communicating with a large retrobulbar haematoma through an orbital roof fracture (Fig. 1 b).

Through a craniotomy about 50 ml of coagulated blood was removed from the epidural space, a decompression of the orbital fractures was made and the retrobulbar haematoma was removed. CT 5 days later showed considerable regression of the retrobulbar haematoma and exophthalmos. The patient was discharged after 2 weeks with almost normalized vision and only slight exophthalmos.