Clinico-radiological features and treatment outcomes in children with traumatic orbital subperiosteal hematoma

Singh, Manpreet; Seth, Natasha Gautam; Zadeng, Zoramthara; Kaur, Manpreet; Gupta, Pankaj

doi:10.1016/j.jaapos.2018.08.004

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…7 The weaker bony adhesions of the periosteum in children also make them susceptible to subperiosteal hematoma after trauma, regardless of an orbital fracture. 4,10 In our case, the absence of a positive forced duction test and no orbital fractures on CT ruled out a trapdoor fracture or soft tissue entrapment. 3 Prompt surgical intervention is crucial for entrapment of extraocular muscles or soft tissue in an orbital bone fracture due to the risk of severe complications, including bradycardia, persistent diplopia, and mortality, making it a top priority in differential diagnosis.…”

Section: Discussionmentioning

confidence: 60%

“…Orbital CT is crucial for accurate diagnosis, guiding treatment, and timely intervention to prevent complications. 10 In guiding our differential diagnosis, the patient's trauma history and clinical observations are crucial. An isolated rectus muscle hematoma, unlike acute diffuse orbital hemorrhage, suggests a mechanism linked to direct injury to the rectus muscle area rather than changes in intra-orbital pressure seen in blow-out fractures.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Isolated medial rectus hematoma following blunt trauma-a novel case report

Güvenç,

Yılmaz Çınar,

Şingar

et al. 2024

AOR

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This report presents a rare case of isolated medial rectus hematoma following blunt trauma in a 16-year-old male. Typically, traumatic eye injuries lead to orbital fractures or hemorrhages, but isolated rectus muscle injury and hematoma are exceptionally uncommon. Our patient exhibited unilateral total outward gaze limitation, esotropia, and horizontal diplopia without any associated cranial or orbital fractures. Orbital CT and MRI played pivotal roles in diagnosing the isolated hematoma, which was managed conservatively with oral corticosteroids, leading to complete resolution of symptoms and radiologic findings within a month. This case underscores the importance of thorough clinical examination and careful evaluation of imaging in the differential diagnosis of posttraumatic diplopia, highlighting the diagnostic challenges and the clinical utility of orbital imaging in such rare presentations.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Isolated medial rectus hematoma following blunt trauma-a novel case report

Güvenç,

Yılmaz Çınar,

Şingar

et al. 2024

AOR

View full text Add to dashboard Cite

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“…In pediatrics, orbital subperiosteal hematoma accounts for less than 1% of spaceoccupying lesions [1]. There are reports of post-traumatic orbital subperiosteal hematoma in children; however, the youngest age reported is two years [3]. We report the successful management of subperiosteal orbital hematoma in an infant.…”

Section: Discussionmentioning

confidence: 90%

Posttraumatic Subperiosteal Orbital Hematoma With Intracranial Hemorrhage in A Male Infant

Lee

Yoo

2021

Preprint

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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

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“…3,14 Orbital subperiosteal hematomas have however been reported in older children (mean age 6.8 years) due to the periosteum being less firmly adherent over the orbital bones except at the suture lines and orbital rim where the attachment is firmer. 19 In older children, blunt trauma to the head and neck can cause rupture of the subperiosteal vessels in the orbital region and formation of a hematoma, which, if severe enough, can lead to orbital compartment syndrome. Other reported causes of subperiosteal hematomas in humans include previous craniofacial surgery, hematologic disease, or anticoagulation therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In the human literature, subperiosteal hematomas of the skull are most often the result of birth trauma or head injuries in infants 3,14 . Orbital subperiosteal hematomas have however been reported in older children (mean age 6.8 years) due to the periosteum being less firmly adherent over the orbital bones except at the suture lines and orbital rim where the attachment is firmer 19 . In older children, blunt trauma to the head and neck can cause rupture of the subperiosteal vessels in the orbital region and formation of a hematoma, which, if severe enough, can lead to orbital compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

Canine calvarial subperiosteal hematomas are fluid to soft tissue attenuating mass‐like lesions with smoothly marginated peripheral mineralization on CT

Nowak

King

Ansón

2020

Vet Radiology Ultrasound

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Subperiosteal hematomas are accumulations of blood between a bone and the periosteum leading to elevation of the periosteum. When ossified they have a mineralized outer rim. For this retrospective, multi-institutional case series, medical records were searched to identify dogs that underwent CT for focal calvarial swellings noted acutely after trauma. A total of four dogs were included. Computed tomography images were reviewed for each case. The focal swellings had progressed in size during the weeks after the head trauma until the time of imaging. Findings in all cases included a fluid to soft tissue attenuating mass-like lesion with smoothly marginated peripheral mineralization. Diagnosis was confirmed in two cases by cytology and/or histopathology. Therefore, authors recommend that subperiosteal hematoma be included in the differential diagnosis list for dogs with these clinical and CT characteristics. Based on our review of the literature, this is the first report to describe the CT features of calvarial subperiosteal hematomas in dogs.

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Clinico-radiological features and treatment outcomes in children with traumatic orbital subperiosteal hematoma

Cited by 5 publications

References 12 publications

Isolated medial rectus hematoma following blunt trauma-a novel case report

Isolated medial rectus hematoma following blunt trauma-a novel case report

Posttraumatic Subperiosteal Orbital Hematoma With Intracranial Hemorrhage in A Male Infant

Canine calvarial subperiosteal hematomas are fluid to soft tissue attenuating mass‐like lesions with smoothly marginated peripheral mineralization on CT

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