Akiyama Yukinori, Ohtaki Masafumi, Kim Sangnyon, Kimura Yuusuke, Mikuni Nobuhiro
*Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo †Department of Neurosurgery, Obihiro Kosei Hospital, Obihiro, Japan.
J Craniofac Surg. 2015 Sep;26(6):e542-3. doi: 10.1097/SCS.0000000000002036.
An intraorbitalsubperiosteal hematoma is a rare clinical entity that is usually caused by head trauma. The authors experienced a patient involving an intraorbital hemorrhage that was associated with minor injury in the forehead and that required surgical decompression. The authors describe this rare case involving an intraorbitalsubperiosteal hematoma that occurred in a conscious young boy who had no remarkable head injury and who had sudden onset of proptosis. Three-dimensional computed tomography, which was conducted with a volume-rendering method, was very useful, and the transorbital approach that was used to remove the hematoma was very effective. The patient showed good recovery. The pathogenesis of the intraorbitalsubperiosteal hemorrhage could not be fully explained, and, thus, the authors suggest that a possible pathogenesis involved the migration of the hemorrhage from the forehead into the intraorbital region.
眶内骨膜下血肿是一种罕见的临床病症,通常由头部外伤引起。作者遇到一名患者,其眶内出血与前额轻微损伤有关,需要进行手术减压。作者描述了这例罕见的眶内骨膜下血肿病例,该病例发生在一名意识清醒的小男孩身上,他没有明显的头部损伤,却突然出现眼球突出。采用容积再现法进行的三维计算机断层扫描非常有用,用于清除血肿的经眶入路也非常有效。患者恢复良好。眶内骨膜下出血的发病机制尚不能完全解释清楚,因此,作者认为一种可能的发病机制是出血从前额迁移至眶内区域。