Orbital Roof "Blow-in" Fracture: A Case Report and Review

We report a relatively rare case of an essentially isolated orbital roof "blow-in" fracture in a pediatric patient.  A 13-year-old male presented with headache and nausea following blunt facial trauma sustained during a skate boarding accident.  CT head revealed soft tissue swelling and an abnormal bony density in the superior, posterior right orbital region.  Follow-up CT orbits revealed a comminuted orbital roof "blow-in" fracture with involvement of the ethmoid air cells and two tiny foci of intracranial air.  Expert consultation revealed normal ophthalmologic and neurologic examination; conservative management was recommended.  The case report is followed by a brief overview of orbital fractures including pertinent radiographic considerations.