Neuroimaging clinics of North America
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In the clinical assessment of orbital trauma, visual acuity and extraocular muscle motility are critical for rapid evaluation of injury severity. However, assessment of these parameters may be limited by edema and concomitant injuries. ⋯ This review focuses on orbital soft-tissue injuries that can exist with or without orbital fracture. Imaging techniques and soft-tissue injuries, including those involving the anterior chamber, iris and ciliary body, lens, globe, posterior segment, and optic nerve, are reviewed, in addition to intraocular foreign bodies and cavernous-carotid fistulas.
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In many respects, craniofacial trauma in children is akin to that in adults. The appearance of fractures and associated injuries is frequently similar. ⋯ In addition, there are unique aspects that must be considered when imaging the posttraumatic pediatric face. Some of these are based on normal growth and development of the skull base and craniofacial structures, and others on the varying etiologies and mechanisms of craniofacial injury in children, such as injuries related to toppled furniture, nonaccidental trauma, all-terrain vehicle accidents, and impalement injuries.
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Knowledge of relevant anatomy and underlying mechanisms of traumatic injury is essential for understanding the radiologic findings in craniofacial trauma and their clinical importance. Craniofacial anatomy is diverse, and as a result of this anatomic diversity, physicians from numerous different specialties scrutinize similar imaging sets, looking for different pathologic abnormalities within the same anatomic regions. Radiologists familiar with the chief concerns of this anatomically diverse region can help expedite the decision-making process by keeping those concerns in mind when they report their findings. This review provides an overview of situations wherein surgical management may be indicated.
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Temporal bone trauma is commonly seen in patients with craniofacial injury and can be detected using multidetector computed tomography. A thorough understanding of the different types of temporal bone fracture patterns is needed to accurately describe the trajectory of injury as well as anticipated complications. Fractures should be described based on direction, segment of temporal bone involved, as well as involvement of the otic capsule. More importantly, the radiologist plays an integral role in identifying complications of temporal bone injury, which often have significant clinical implications.