Proptosis secondary to subdural hematoma

Area of Science:

• Neuroscience
• Ophthalmology
• Radiology

Background:

• Subdural hematomas can present atypically, extending beyond the cranial cavity.
• Orbital involvement from intracranial lesions is rare but clinically significant.
• Accurate diagnosis is crucial to differentiate from neoplastic or congenital causes.

Observation:

• A case of unilateral proptosis without neurological deficits was observed.
• The proptosis was caused by a subdural hematoma extending into the orbit via a sphenoid bone fracture.
• Ultrasonography successfully identified the lesion and associated bony dehiscence.

Findings:

• Percutaneous needle aspiration provided temporary proptosis relief and intracranial decompression.
• Computed tomography (CT) initially suggested a possible tumor, necessitating further investigation.
• The subdural hematoma was effectively managed, preventing neurological complications.

Implications:

• Ultrasonography is a valuable tool for diagnosing orbital masses of intracranial origin.
• Head trauma, even minor, should be considered in the differential diagnosis of proptosis.
• Timely intervention can prevent severe neurological sequelae from orbital subdural hematomas.