Orbital Blowout Fx!

Medial Blowout Fx Inferior Blowout Fx

http://radiopaedia.org/articles/blow-out_fracture

Orbital blowout fx are usually the result of blunt force trauma to the orbital rim. Examples of this type of trauma would be contact with a baseball, a baseball bat, MVA, and a fist. In an orbital fx, the blunt force "blows" out the floor or adjacent wall of the rim of the orbit. In most cases, it usually occurs in the inferior floor of the orbit, or the medial wall of the orbit. Also, the nasal bones are usually broken as well especially when the blowout fx involves the medial wall of the orbit.

Symptoms of an Orbital Blowout Fx are:

Pain

Diplopia on an upward stare - related to involvement on orbital muscles.

Enophthalmos - related to increased swelling and preasure in the orbital globe.

Facial numbness - related to inferior orbital nerve

Nose bleed

Orbital hemorrhage may occur

Imaging the Orbits

CT with coronals and axials specifically.

MRI with coronals and axials specifically, be sure to use fat suppression technique during exam.

Xray in the waters position especially.

Tx for Orbital Blowout Fx

Surgical repair of orbital blowout fx when:

More than 1/2 of the orbit floor or wall is invovled

Diplopia does not quickly resolve itself

Enophthalmos >2mm

Surgical repair usually involved a form of bone graft, synthetic material, or plate to fix the hole in the orbital rim.

Orbital blowout fx that go untreated, and have significant obital muscle, optic nerve, and acute bone damage can lead to long term visual defects as well as enophthalmos.

http://www.learningradiology.com/

Pituitary Macroadenoma

http://www.mdanderson.org/images/macrodenoma.jpg

Additional images and radiology based information at (I thought it was interesting)!:
http://www.urmc.rochester.edu/SMD/rad/neurocases/Neurocase81.htm



Pituitary Macroadenoma is a a benign pituitary tumor of a size greater than 10mm. It must measure greater than 10mm to be considered a macroadenoma. If the tumor measures smaller than 10mm it would then be considered a pituitary microadenoma. The pituitary gland controls and regulates growth, metabolism, and reproduction in the human body.

Patients with pituitary macroadenoma may present with the following symptoms:

• weakness




• fatigue




• restlessness




• headaches




• nausea




• vomiting




• vertigo




• changes in hair growth




• changes in body weight




• loss of vision due to the macroadenoma compressing the optic nerve

Diagnosing a pituitary macroadenoma begins with the following tests being ordered by a physician. More common diagnosis processes include: blood tests, urine test, CT scans, and MRI scan; however some less common tests may include petrosal sinus samplings, and certain eye exams.Treating a pituitary macroadenoma include surgery to remove the tumor, radiation therapy to kill the tumor, and also a range of drug therapies depending on the patient's age and overall health. If left untreated, and depending on the hormone that the macroadenoma is secreting several additional diseases can develop such as: Cushing's disease, Acromegaly, Lack of menstruation, Abnormal production of breast milk, and even Diabetes Insipidus.