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What is the treatment? 31 02 Pages 25-74 16 21/11/01 11:12 am Page 32 (Black plate) Answers Radiology for Surgeons 1. There is a ‘teardrop’ sign arising from the floor of the left orbit indicating an orbital floor fracture: this is otherwise known as a blow-out fracture. 2. Clinical relevance and features: herniation of peri-orbital fat into the maxillary antrum, and there may be trapping of the inferior rectus muscle, both of which cause diplopia. 3. Additional clinical features: • Ballooning oedema around the orbit.

3. 4. What does the CT scan show? What is the diagnosis? What is the mechanism of injury? How is the condition treated? 41 02 Pages 25-74 21 21/11/01 11:12 am Page 42 (Black plate) Answers Radiology for Surgeons 1. There is a concavoconvex area of high attenuation overlying the left frontal lobe. 2. • Diagnosis: acute subdural haemorrhage. • Note that in some circumstances when the subdural is large, it may take a convex appearance and mimic an acute extradural haematoma. 3. Acute subdural haemorrhage usually occurs in association with cortical laceration – most frequently anterior temporal or frontal regions: • Depressed fracture.

2. 3. 4. 5. What does the CT scan show and what is the diagnosis? What is a ‘typical history’ for such an injury? Describe th e common sites for this injury. What is the management of this condition? What are the secondary complications of head injuries? 25 02 Pages 25-74 13 21/11/01 11:12 am Page 26 (Black plate) Answers Radiology for Surgeons 1. • There is a biconvex area of increased attenuation overlying the left temporal region. A further ill-defined area of high attenuation is seen within the parenchyma of the right temporal lobe.

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