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Intracranial Displacement of the Eye After Blunt Trauma

Miabi, Zinat MD; Nezami, Nariman MD; Midia, Mehran MD; Midia, Ramin MD

Journal of Neuro-Ophthalmology: December 2009 - Volume 29 - Issue 4 - p 311
doi: 10.1097/WNO.0b013e3181bef65b
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A 67-year-old man fell from an agricultural vehicle and struck his right eye on a protruding element. Eight hours later, he was brought to the emergency unit of an ophthalmology hospital where examiners could not find the right eye and believed it to have been completely destroyed. However, CT disclosed that the eye, apparently still intact, had been displaced into the anterior cranial fossa through a fracture in the orbital roof. This is the first documentation of such a phenomenon.

Department of Radiology (ZM, NN) and Drug Applied Research Center (NN), Tabriz University (Medical Sciences), Tabriz, Iran; Young Researchers Club (NN), Tabriz Islamic Azad University, Tabriz, Iran; Department of Radiology (MM), McMaster University, Hamilton, Ontario, Canada; and Department of Radiology (RM), University of Iowa Health Care, Iowa City, Iowa.

Address correspondence to Dr. Nariman Nezami, MD, Clinical Pharmacy Laboratory, Drug Applied Research Center, Tabriz University (Medical Sciences), Pashmineh, Daneshgah Street, Tabriz, Iran. E-mail: dr.nezami@gmail.com

A 67-year-old man fell accidentally from a tractor. His right eye struck a protruding part of the vehicle. He experienced massive bleeding from his right eye and a 3 to 5-minute period of unconsciousness. Eight hours later, he was brought to the emergency unit of an ophthalmology hospital where examiners could not find the right eye and believed it to have been completely destroyed. The orbit was irrigated and an upper eyelid laceration was repaired.

Throughout 7 days of hospitalization and 7 days of partial bed rest at home, the patient complained of severe right frontal headache. CT (Fig. 1) revealed that the right eye appeared to be intact and had herniated through a bony defect in the right orbit roof and substantially into the floor of the anterior fossa.

FIG. 1

FIG. 1

As far as we know, there have been no case reports demonstrating trauma-induced intracranial dislocation of an intact eye.

© 2009 Lippincott Williams & Wilkins, Inc.