保存的治療で寛解した外傷性眼窩内骨膜下血腫の1例

Spontaneous cure in a case of subperiosteal hematoma in the orbit

　鈍的頭部外傷後に眼窩内骨膜下血腫が出現し，比較的短期間に眼症状の改善が認められた症例を経験した．外傷性眼窩内骨膜下血腫は血腫が著明で進行性に眼球突出をきたし，血腫の除去，穿刺吸引が必要である例が多い．

　本例は眼球突出が軽度で，短期間に眼症状が改善したまれなものであった．鈍的頭部外傷の既往および眼球運動障害があることから本疾患は吹抜け骨折とよく似た臨床像を示す場合がある．治療法が全く異なるため早期に鑑別しなければならない．

A 13-year-old male developed diplopia after accidentally colliding with his classmate with the head. We observed mild proptosis and hypodevia-tion of his left eye. The left eye also showed restricted movement upwards, inwards and out-wards. Computed tomography showed a space-oc-cupying lesion adjacent to the upper wall of the left orbit. The condition followed a favorable clinical course after systemic corticosteroid. Remarkable improvements in ocular motility resulted 1 month after the injury and diplopia disappeared 5 months later. The patient was free of optic nerve damage or raised intraocular pressure throughout.