Limits...
Retrobulbar hematoma from warfarin toxicity and the limitations of bedside ocular sonography.

Thompson D, Stanescu C, Pryor P, Laselle B - West J Emerg Med (2010)

Bottom Line: The following case describes a 26-year-old female who presented to the emergency department with a nontrauamtic retrobulbar hematoma associated with warfarin toxicity.The application and limitations of focused bedside ocular sonography for this condition are discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA.

ABSTRACT
The following case describes a 26-year-old female who presented to the emergency department with a nontrauamtic retrobulbar hematoma associated with warfarin toxicity. The application and limitations of focused bedside ocular sonography for this condition are discussed.

No MeSH data available.


Related in: MedlinePlus

Ultrasound images of left (symptomatic), which failed to demonstrate a hyperechoic fluid collection in the retro-ocular region & right (asymptomatic) orbits.
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f1-wjem-11-208: Ultrasound images of left (symptomatic), which failed to demonstrate a hyperechoic fluid collection in the retro-ocular region & right (asymptomatic) orbits.

Mentions: The physical exam was remarkable for slight left eye proptosis, left periorbital edema without evidence of trauma and an inferiorly displaced left gaze. Extraocular movements of the left eye were limited in attempted rightward gaze. Visual acuity seemed unchanged, as demonstrated by correct finger counting at four feet (the patient did not wear her contact lenses during the evaluation). Visual fields were intact. Intraocular pressure (IOP) was 30 mm Hg on the left, and 18mm Hg on the right. A focused bedside ocular ultrasound (Figure 1) was performed by an emergency ultrasound fellow. The ultrasound fellow had previously performed approximately 500 bedside ultrasound examinations and 15 ocular ultrasound evaluations. The findings of this examination were documented in real-time as: “compared to the asymptomatic eye there is evidence of slight proptosis and slight fullness of the soft-tissue in the retro-orbital region. There is no clear evidence of RBH, vitreous hemorrhage or retinal detachment.” Non-contrast head computed tomography (CT), obtained approximately 45 minutes after the bedside ultrasound, demonstrated a large left RBH with associated proptosis (Figure 2). No repeat ultrasound examination was performed following the head CT.


Retrobulbar hematoma from warfarin toxicity and the limitations of bedside ocular sonography.

Thompson D, Stanescu C, Pryor P, Laselle B - West J Emerg Med (2010)

Ultrasound images of left (symptomatic), which failed to demonstrate a hyperechoic fluid collection in the retro-ocular region & right (asymptomatic) orbits.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2908661&req=5

f1-wjem-11-208: Ultrasound images of left (symptomatic), which failed to demonstrate a hyperechoic fluid collection in the retro-ocular region & right (asymptomatic) orbits.
Mentions: The physical exam was remarkable for slight left eye proptosis, left periorbital edema without evidence of trauma and an inferiorly displaced left gaze. Extraocular movements of the left eye were limited in attempted rightward gaze. Visual acuity seemed unchanged, as demonstrated by correct finger counting at four feet (the patient did not wear her contact lenses during the evaluation). Visual fields were intact. Intraocular pressure (IOP) was 30 mm Hg on the left, and 18mm Hg on the right. A focused bedside ocular ultrasound (Figure 1) was performed by an emergency ultrasound fellow. The ultrasound fellow had previously performed approximately 500 bedside ultrasound examinations and 15 ocular ultrasound evaluations. The findings of this examination were documented in real-time as: “compared to the asymptomatic eye there is evidence of slight proptosis and slight fullness of the soft-tissue in the retro-orbital region. There is no clear evidence of RBH, vitreous hemorrhage or retinal detachment.” Non-contrast head computed tomography (CT), obtained approximately 45 minutes after the bedside ultrasound, demonstrated a large left RBH with associated proptosis (Figure 2). No repeat ultrasound examination was performed following the head CT.

Bottom Line: The following case describes a 26-year-old female who presented to the emergency department with a nontrauamtic retrobulbar hematoma associated with warfarin toxicity.The application and limitations of focused bedside ocular sonography for this condition are discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA.

ABSTRACT
The following case describes a 26-year-old female who presented to the emergency department with a nontrauamtic retrobulbar hematoma associated with warfarin toxicity. The application and limitations of focused bedside ocular sonography for this condition are discussed.

No MeSH data available.


Related in: MedlinePlus