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VEHERI CT Teleradiology Case Report*
Priority: Express | Modality: CT | Region: Head and Hips | Study: Pre- and post-contrast CT of head and pelvis
PATIENT & REQUEST DETAILS
• 2-year old feline, male, neutered, Domestic Shorthair. Traffic accident, primarily involving the head
Questions
• What is the extent of skull and pelvic damage?
• Which areas may require surgical stabilization to heal?
• Is there visible soft tissue injury?
• Any injury to the neck region?
• Are the brain and eyes normal on this scan?
FINDINGS
Head – Skull:
• Slightly dorsally displaced fracture of the left temporal bone at the medial aspect of the mandibular fossa, immediately at the junction with the calvarium.
• Nondisplaced fracture of the rostral zygomatic process of the left temporal bone (Fig.4).
• Bilateral fractures of the orbital plates of the ethmoid bones with minimal medial displacement (Fig.2).
• Non-displaced bilateral fractures of the pterygoid bones (Fig.1).
• Bilateral fractures of the orbital processes of the frontal bones with minimal medial displacement …*
Head – Mandibles:
• There is a slight malalignment of the mandibular symphysis with slight ventral displacement of the right rostral mandible. A focal comminuted fracture of the right rostromedial mandible is identified with associated tiny, minimally displaced fragments.
• There is a slight ill-defined soft tissue swelling along the buccal aspect of the mandible.
• Comminuted complex fracture of the ramus of the right mandible. The fracture lines propagate from the base of the condylar process towards the angle of the mandible producing multiple geometrical sharply marginated fragments (Fig.3). The longest fragment measure ca. 8 mm. The articular surface is normal, and the temporomandibular joint is congruent. …*
Further findings
• The included cervical vertebral column and the alignment of the vertebrae (C1 –C3) is normal.
• There are no intracranial abnormalities. The calvarium is intact.
• There is a moderate amount of ill-defined non-enhancing soft tissue attenuation in the right and left nasal cavities.
• No lymphadenopathy identified.
• The eyes, larynx, ear canals and tympanic bullae are normal.
• The dentition is normal.
Pelvis
• The hemipelves are symmetric.
• The sacroiliac joints are well-aligned.
• The femoral heads are within the acetabula.
• The sacral bone is normal.
• The associated soft tissues are normal.
SUMMARY
• Multiple fractures of the skull in the facial region (Fig.1-4).
• Comminuted fracture of the right mandibular ramus with mild associated soft tissue swelling (oedema, bruising).
• Nondisplaced articular fracture of the condylar process of the left mandibula.
• Separation of the mandibular symphysis with slight displacement and associated fracture of the rostromedial right mandible.
• There is no tomographic evidence of brain trauma.
RECOMMENDATIONS
Surgical consult: The fracture of the right mandibular ramus and the mandibular symphysis may require surgical intervention. A consultation with a surgeon is advised.
*This report has been shortened for editorial reasons.
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