PMC4553660_01
Case 1. (a) Three-dimensional recontruction showing the injury pattern and extensive facial trauma suffered by this 17-year-old male. (b) Axial head computed tomography (CT) scan demonstrating bilateral subdural hematomas with associated cerebral edema and moderate amount of pneumocephalus. (c) Axial CT scan of the facial bones displaying a comminuted fracture through the frontal sinus with disruption of the anterior and posterior tables. The degree of displacement is less than full width. There is associated nasofrontal outflow tract obstruction and moderate right frontal pneumocephalus. (d) Postoperative axial head CT scan demonstrating interval resolution of the subdural fluid collections as well as successful cranialization of the frontal sinus
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F2
CT three-dimensional surface rendering showed the extent of the facial trauma and injury pattern [Figure 2a]; the initial head CT [Figure 2b] showed evidence of bilateral subdural hematomas and right frontal pneumocephalus with an associated fracture through the frontal sinus. CT of the facial bones [Figure 2c] showed not only a fracture through the anterior and posterior tables, but also evidence of NFOT obstruction. Postoperative head CT [Figure 2d] shows interval cranialization of the frontal sinus and repair of the fracture.
PMC4553660_02
Case 2. (a) Axial head computed tomography (CT) scan with bone windows demonstrating right frontal sinus fracture with near-complete opacification of the frontal sinus; the fracture extended through the anterior and posterior tables and was greater than the full width of the frontal sinus. (b) Postoperative head CT showing successful cranialization of the frontal sinuses and residual pneumocephalus. (c) Follow-up head CT, approximately 1.5 months after surgical intervention, demonstrating good bony healing with significant resolution of the cerebral edema and mass effect
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F3
The bullet had caused massive orbital, facial trauma, including a right frontal sinus fracture with near-complete opacification of the frontal sinus [Figure 3a]. Postoperative head CT [Figure 3b] showed successful cranialization of the frontal sinuses and residual pneumocephalus. The follow-up head CT [Figure 3c] displayed postsurgical changes with significant resolution of the cerebral edema and mass effect.