Case Notes
History
54 yo male unwitnessed ATV accident. Found down by bystanders. Suspicion of Etoh intoxication. Intubated on scene, hemodynamically stableExam
Noncontrast head CT
Prior Study
Bone window CT head and upper Cspine1. Multiple sites of bone injury including a LeFort-3 fracture complex on the right, a high convexity laterofrontal comminuted fracture with 4 mm depressed fracture, a fracture of the right orbital apex, a fracture of the left EAC likely extending into the adjacent mandibular space, and there is minimal diastasis of the left lambdoid suture. There are multiple nondisplaced upper Cspine chronic fractures without canal compression. However, the multiplicity and the overall severe impact cerebral injuries would suggest that these cervical injuries be considered unstable at the present time.
2. Depressed right orbital roof fracture has produced right orbital (non-focal) intraconal, extraconal retroglobal hemorrhage leading to ocular proptosis without ocular tenting. There is possible focal blood within Tenon's space.