Intradiploic hematoma of the frontal bone with secondary exophthalmos in a mare

Abstract

A 13-year-old cob mare was presented with exophthalmos and periocular swelling of the left eye. The diagnostic work-up included ocular ultrasound, sonographic examination through the thinned frontal bone, radiography, standing computed tomography of the skull and exploratory osteoplastic surgery. Histopathology was consistent with an organized hematoma. An intradiploic hematoma of the frontal bone was diagnosed 5 years after head trauma, with progressive expansion and deformation of the skull resulting in exophthalmos. Exophthalmos with facial bone deformation was the only clinical finding of intradiploic hematoma. Standing computed tomography (CT) aided the diagnosis to differentiate intradiploic hematoma from other, more common causes of facial bone distortion associated with paranasal sinus diseases. Intradiploic hematoma of possible traumatic origin is a differential diagnosis for sinonasal disease and exophthalmos in the horse.

Equine orbital disease: A review

“…Rarely, trauma to the equine skull can lead to the formation of cyst‐like lesions resulting in facial deformity and exophthalmos (Caldwell ; Kafarnik et al . ). These lesions can be tentatively diagnosed using skull radiographs or CT imaging.…”

Best way to assess the sphenopalatine sinus

“…In three of the case reports (Smith and Perkins ; Kafarnik et al . ; Federici et al . ), radiographic findings underestimated the extent of the lesion and failed to identify involvement of the SP sinus, which was subsequently diagnosed by CT. Behrens et al .…”

“…It should be considered in all cases of sinus disease as the SP sinus is often involved secondarily and its involvement may reduce the prognosis . Radiographs are a useful screening tool for the presence of sinus disease (Cissell et al 2012), but they often underestimate the extent of lesions, their true location and the presence of bilateral disease (Smith and Perkins 2009;Textor et al 2012;Kafarnik et al 2014;Federici et al 2015). Contrast-enhanced CT may offer an advantage for outlining sinus masses (Cissell et al…”

Equine retrobulbar disease: Diagnoses and outcomes of 15 horses with exophthalmos (1988–2017)

“…) and one with a haematoma (Kafarnik et al . ). It is difficult to make predictions about prognosis for survival for specific retrobulbar disease processes in horses when only data from individual cases and small case series are available.…”