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Black eyebrow sign - orbital blow-out fracture

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Young man with trauma to left eye after a night on the town.

Patient Data

Age: 25
Gender: Male

Linear lucency in the left superior orbit - black eye-brow appearance.

Linear lucency at the superior aspect of the left orbital - intra-orbital emphysema.

Inferior orbital wall intact.

CT - intra-orbital air clearly delineated, along with medial orbital wall (laminae papyracea) fracture from which the air has leaked into the orbit.

Case Discussion

The black eyebrow sign of intra-orbital emphysema, almost always in the context of an orbital fracture, in which air has leaked into the orbit from the ethmoidal or maxillary sinus.

It may be an isolated fracture or in the context of an orbital blow out fracture.

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