Exophthalmos as a presenting sign of extradural haematoma

A conscious 14-year old boy admitted to hospital with progressive right exophthalmos, decreased visual acuity and headache 9 days after head trauma, with neurological deficit. Computerized tomography [CT] scan demonstrated intracranial and intraorbital cystic mass. At craniotomy, a subacute extradural haematoma was found which communicated with an orbital subperiosteal haematoma through an orbital roof fracture. Postoperative outcome was marked by complete recovery of exophthalmos and visual acuity. This case demonstrated the rare diagnosis of epidural and subperiosteal orbital haematoma. The literature is reviewed and surgical management is discussed