Inferior ‘trapdoor’ orbital floor fractures with muscle and soft tissue incarceration are the most common type of orbital fracture in children. Delays to treatment can lead to a significant morbidity. It has been recommended that children who present with a ‘white-eyed blowout’ fracture should have surgery performed within 48h of diagnosis, otherwise prognosis is poor. A 14-year-old boy was initially misdiagnosed with a head injury due to the minor appearance of his orbital injury and his presenting complaint of nausea and vomiting. This resulted in a significant delay to surgery. The oculovagal reflex associated with orbital injuries is well documented (Wei and Durairaj in Pediatric orbital floor fractures. J AAPOS 2011;15:173–80). It should be considered by emergency department and paediatric staff when dealing with patients who have sustained a blow to the orbital region, despite not having a subconjunctival haemorrhage. The importance of examination to detect other features of orbital blow-out and entrapment are stressed.

No abstract

A space-occupying lesion of the brain is commonly due to malignancy but could be other underlying pathologies as well [1]. The effects of SOL may be local or due to compression of adjacent brain structures. Patients may also have behavioral disturbances or cognitive dysfunction [2,3]. Aims & Objectives:1. To identify SOL patients presenting with elusive symptoms in Emergency Department. 2. To avoid diagnostic delay of SOL.

No abstract

No abstract