PMC7276167_01
Patient at presentation
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F1
The external examination showed swelling of the bilateral upper lid with left inferior dystopia [Figure 1].
Magnetic resonance imaging of the brain and orbit (coronal view) with contrast showed heterogeneous signal intensity with a peripheral diffusion restriction and faint peripheral enhancement, representing multiple bony infarctions and subperiosteal hematomas within the frontoparietal region bilaterally
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F2
T2-W image. These results occurred with a peripheral diffusion restriction and faint peripheral enhancement, representing multiple bony infarctions and subperiosteal hematomas within the frontoparietal region bilaterally. The MRI also showed a well-defined extraconal lesion, likely to be a hematoma, arising from a superior lateral orbital wall of the left eye, causing mass effect on the ipsilateral lacrimal gland as well as the left lateral rectus muscle [Figure 2].
Intraoperative appearance of the frontal bone
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F3
Interestingly, the bone appeared gray, which may correlate to the bony infarction seen on MRI [Figure 3].
Complete resolution of the periorbital swelling
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F4
During the follow-up visit, the patient's pain decreased, and the dystopia improved [Figure 4].