Citation

Yu Q, Zhu J, Wu H. World Neurosurg. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.wneu.2022.09.093

PMID

36179763

Abstract

A 43-year-old man was admitted to the emergency department for motor vehicle collision. First clinical impression was traumatic injury of the right eye with bare light perception. Physical examination revealed multiple nodular skin lesions on the head and neck. Head MRI and CT scans showed intracerebral hemorrhage, trans-orbital brain herniation, and right sphenoid wing dysplasia. A diagnosis of neurofibromatosis type 1 was made. Sphenoid wing dysplasia (also known as bare orbit sign) in neurofibromatosis type 1 was a contributing factor to the transorbital herniation, but also helped reduce intracranial pressure after traumatic brain injury in this rare case. Mannitol was administered, and no neurosurgical intervention was needed for traumatic brain injury. Canthorrhaphy of the right eye was performed to preserve patient's right eyeball. At 1-month follow-up, patient's right eyeball was preserved, and vision improved as well. A 43-year-old man was admitted to the emergency department for motor vehicle collision. First clinical impression was traumatic injury of the right eye (Figure 1A) with bare light perception. Vital signs and level of consciousness were normal (GCS = 15). Past medical history was insignificant according to the patient. Physical examination revealed multiple nodular skin lesions on the head and neck (white arrows, Figure 1A). Head MRI and CT scans showed intracerebral hemorrhage, trans-orbital brain herniation (Figure 1B), and right sphenoid wing dysplasia (bare orbit sign; white arrow, Figure 1C). A diagnosis of neurofibromatosis type 1 was made.

Language: en

Keywords

Traumatic brain injury; neurofibromatosis type 1; sphenoid wing dysplasia; traumatic ocular injury