Presentation
Recent orbital trauma. Now orbital pain and swelling.
Patient Data
Left orbital roof subperiosteal hematoma with inferior displacment of the periosteum. The hematoma is abutting the superior rectus/levator palpare superiosis complex and the superior aspect of the globe.
No bony orbital fracture lines.
Case Discussion
Orbital subperiosteal hematoma (SO is a rare condition caused by rupture of diploic veins between the periosteum and the bony orbit.
Causes:
Traumatic: As the periosteum is only firmly attached to the bone at the suture lines in old age, the potential space between the periosteum and the bone is more prone to hemorrhage in newborns with birth trauma. As the periosteum's attachment to the bone matures with age, adults are less prone than young children to get subperiosteal hemorrhage.
Non traumatic, such as, increased venous congestion including emesis, weight-lifting, Valsalva maneuver such as during child birth, abnormal bleeding tendencies, such as hepatic disease, and in the setting of paranasal sinusitis
Complications: if hematoma expanded rapidly it might compress the optic nerve leading to ocular deficits.
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