Answer: CT head w/o contrast is the imaging modality of choice. Thin cut coronal sections (1 mm) should be performed for any patient who presents with periorbital trauma.
The patient’s CT head is shown below:
Above Image Courtesy of Kyle Hirabayashi, MD
CT orbits:
What complications do you want to monitor closely for? Pick 1 before moving on.
Extraocular muscle entrapment
Diplopia
Enophthalmos
Proptosis
Sympathetic ophthalmia
Numbness of the lower left eyelid and upper left cheek in our patient case raises concern for involvement of what structure?
Superior orbital neurovascular bundle
Inferior orbital neurovascular bundle
CN II
CN VIII
What systemic findings in our patient may suggest entrapment of the inferior rectus?