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Proptosis as a presenting sign of extradural haematoma
C R Stewart1, J F Salmon, Z Domingo
1Department of Ophthalmology, University of Cape Town, South Africa.
Insights
A rare case of extradural hemorrhage caused proptosis and headache in a 15-year-old boy after head trauma. Prompt surgical drainage of the hematoma led to a full recovery, highlighting the importance of considering this diagnosis.
Area of Science:
- Neurosurgery
- Ophthalmology
- Trauma Surgery
Background:
- Extradural hemorrhage is a rare but serious complication following head trauma.
- Progressive proptosis and severe headache can be presenting symptoms.
Observation:
- A 15-year-old male presented with proptosis and headache two weeks post-trauma.
- CT scan revealed intracranial and intraorbital cyst-like masses.
- Surgical exploration identified a subacute extradural hematoma communicating with an orbital subperiosteal hematoma via an orbital roof fracture.
Findings:
- Surgical drainage of the extradural and subperiosteal hematomas was performed.
- The patient experienced an uneventful postoperative recovery.
Implications:
- Extradural hemorrhage should be considered in the differential diagnosis of proptosis and headache after head injury.
- Early recognition and surgical intervention are crucial for favorable outcomes in such rare cases.
Abstract:
A conscious 15-year-old boy presented with progressive proptosis and a severe headache 2 weeks after minor blunt trauma to the head. No neurological deficit was present. Computed tomography demonstrated intracranial and intraorbital cyst-like masses. At craniotomy a subacute extradural haematoma was found which communicated with an orbital subperiosteal haematoma through a shelved orbital roof fracture. The haematomas were drained and the patient made an uneventful postoperative recovery. Although rare, an extradural haemorrhage should be considered in any patient presenting to an ophthalmologist with progressive proptosis and headache following a head injury.