RESUMO
A 14-year-old patient had a low-energy facial blunt trauma that evolved to right facial paralysis caused by parotid hematoma with parotid salivary gland lesion. Computed tomography and angiography demonstrated intraparotid collection without pseudoaneurysm and without radiologic signs of fracture in the face. The patient was treated with serial punctures for hematoma deflation, resolving with regression and complete remission of facial paralysis, with no late sequela. The authors discuss the relationship between facial nerve traumatic injuries associated or not with the presence of facial fractures, emphasizing the importance of early recognition and appropriate treatment of such cases.
Assuntos
Traumatismos dos Nervos Cranianos/etiologia , Traumatismos Faciais/complicações , Paralisia Facial/etiologia , Hematoma/etiologia , Glândula Parótida/lesões , Ferimentos não Penetrantes/complicações , Adolescente , Angiografia , Traumatismos dos Nervos Cranianos/diagnóstico por imagem , Traumatismos dos Nervos Cranianos/terapia , Traumatismos Faciais/diagnóstico por imagem , Traumatismos Faciais/terapia , Paralisia Facial/diagnóstico por imagem , Paralisia Facial/terapia , Hematoma/diagnóstico por imagem , Hematoma/terapia , Humanos , Masculino , Glândula Parótida/diagnóstico por imagem , Punções , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/terapiaRESUMO
Occipital condyle fracture(OCF) is rarely seen and can be missed during medical evaluation due to the variety of clinical presentations and the difficulty to be visualized radiographically. This fracture can be associated with cranial nerves injuries (31%), being the hipoglossal nerve the most frequently involved (67%). We report a 58 years old female patient who presented with OCF, injury of lower cranial nerves and Jefferson's fracture. The patient was treated with cervical traction for six weeks followed by halo immobilization for three months. There was bone consolidation recovery of the nervous injury after this period. This report emphazises the importance of investigating the skull-cervical transition in all patients with cervical trauma. Although Jefferson's fracture is rarely associated with OCF, it should be remembered and treated appropriately when diagnosed.