Borumandi Farzad
Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria.
BMJ Case Rep. 2013 Dec 9;2013:bcr2013202216. doi: 10.1136/bcr-2013-202216.
Compared to the cerebrospinalfluid (CSF) leak through the nose and ear, the orbital CSF leak is a rare and underreported condition following head trauma. We present the case of a 49-year-old woman with oedematous eyelid swelling and ecchymosis after a seemingly trivial fall onto the right orbit. Apart from the above, she was clinically unremarkable. The CT scan revealed a minimally displaced fracture of the orbital roof with no emphysema or intracranial bleeding. The fractured orbital roof in combination with the oedematous eyelid swelling raised the suspicion for orbital CSF leak. The MRI of the neurocranium demonstrated a small-sized CSF fistula extending from the anterior cranial fossa to the right orbit. The patient was treated conservatively and the lid swelling resolved completely after 5 days. Although rare, orbital CSF leak needs to be included in the differential diagnosis of periorbital swelling following orbital trauma.
与通过鼻和耳的脑脊液（CSF）漏相比，眼眶脑脊液漏是头部外伤后一种罕见且报道不足的情况。我们报告一例49岁女性病例，在看似轻微的右侧眼眶跌倒后出现眼睑水肿和瘀斑。除此之外，她临床上无异常。CT扫描显示眶顶有轻度移位骨折，无气肿或颅内出血。骨折的眶顶与眼睑水肿相结合引发了眼眶脑脊液漏的怀疑。颅神经MRI显示一个小型脑脊液瘘管从前颅窝延伸至右侧眼眶。患者接受了保守治疗，眼睑肿胀在5天后完全消退。尽管罕见，但眼眶脑脊液漏需要纳入眼眶外伤后眶周肿胀的鉴别诊断中。
