Waring G O, Flanagan J C
Arch Ophthalmol. 1975 Sep;93(9):847-50. doi: 10.1001/archopht.1975.01010020727012.
Fractures of the orbit resulting from blunt or penetrating injury that involve the paranasal sinuses may tear the dura and allow air to enter the cranial cavity (pneumocephalus). Pneumocephalus is sometimes the only sign of intracranial involvement. It is characteristically delayed in onset and clinically unsuspected, so that routine follow-up roentgenograms of patients with orbitosinus fractures may be the only means of assuring early detection. Roentgenographically, the air may be seen in spidural, subdural subarachnoid, intracerebral, or intraventricular locations. Prophylactic parenterally administered antibiotics may prevent intracranial infection. However, since about 25% of patients still develop meningitis, surgical repair of the dural fistula is often necessary.
钝器伤或穿透伤导致的累及鼻窦的眼眶骨折可能会撕裂硬脑膜，使空气进入颅腔（气颅）。气颅有时是颅内受累的唯一迹象。其发病通常延迟，临床上难以察觉，因此眼眶鼻窦骨折患者的常规随访X线片可能是确保早期发现的唯一手段。在X线片上，空气可见于硬膜外、硬膜下、蛛网膜下、脑内或脑室内部位。预防性胃肠外给予抗生素可预防颅内感染。然而，由于约25%的患者仍会发生脑膜炎，通常需要对硬脑膜瘘进行手术修复。
