PMC7265386_01
The first brain computed tomography scan shows fracture of the orbital roof and frontobasal hemorrhagic contusion.
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F1
The CT studies revealed; (1) a right frontal orbital fracture with parenchymal right frontal brain contusion and an osteodural breach (e.g., displaced fracture of the roof of the right orbit extending to the ipsilateral upper wall/frontal bone) [Figure 1], (2) a nonenhancing low-density fluid collection anterior to the right eyeball and communicating with the right subarachnoid space, and (3) a chronic right low-density subdural hematoma [Figure 2].
The second brain computed tomography scan showing an intraorbital collection communicating with the right frontal subarachnoid space.
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F2
The CT studies revealed; (1) a right frontal orbital fracture with parenchymal right frontal brain contusion and an osteodural breach (e.g., displaced fracture of the roof of the right orbit extending to the ipsilateral upper wall/frontal bone) [Figure 1], (2) a nonenhancing low-density fluid collection anterior to the right eyeball and communicating with the right subarachnoid space, and (3) a chronic right low-density subdural hematoma [Figure 2].
Postoperative brain computed tomography scan showing the resolution of intraorbital meningocele and exophthalmia.
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F3
The postoperative CT scan documented the same findings as recounted above [Figure 3].
Esthetical evolution before surgery (a), 2 months after the first surgery (b), final result after 1 year of follow-up (c).
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F4
Further, there was an improvement in the downward gaze/displacement/ ophthalmoplegia [Figure 4].
PMC7265386_02
Matinal aspect with solid right eye inner canthus tumefaction and lacrimation observable on the t-shirt.
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F5
Six years later, he presented with a solid right eye inner canthus lesion accompanied by increased lacrimation but without any visual loss [Figure 5].
The right intraorbital cyst and temporal and frontal arachnoid cyst.
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F6
The brain CT scan showed a right intraorbital cystic mass plus a temporal/frontal arachnoid cyst [Figure 6].
Final aspect after the third surgery.
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F7
Finally, 3 months after the final procedure, the patient's CSF leak resolved, along with the inner canthus lesion, but there was persistent/residual slight downward displacement of the right eye [Figure 7].