Non-Traumatic Subperiosteal Orbital Hematoma After Cardiopulmonary Resuscitation: A Case Report.
4 affiliations
- 1Department of Ophthalmology, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
- 2Department of Ophthalmology, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia.
- 3Molecular Pathology Unit, Cancer Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.
- 4Department of Ophthalmology, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
Abstract
Subperiosteal orbital hemorrhage is a rare condition that is typically observed following direct facial or orbital trauma. Non-traumatic subperiosteal orbital hemorrhage (NTSOH) has been infrequently reported in association with sudden elevations in cranial venous pressure or venous congestion. To the best of our knowledge, this is the first reported case of NTSOH associated with cardiopulmonary resuscitation (CPR). A 48-year-old woman with end-stage renal disease developed cardiac arrest while undergoing hemodialysis. CPR was performed for 24 minutes, resulting in the successful return of spontaneous circulation. Contrast-enhanced computed tomography of the brain incidentally revealed a 2.6 × 2.4 × 1.2 cm mixed-density subperiosteal lesion along the roof of the right orbit with a smooth lateral margin, causing inferior displacement of the superior rectus muscle, consistent with an acute subperiosteal hematoma. The patient's coagulation profile and full blood count were within normal limits. Ophthalmic examination demonstrated mild right-sided proptosis and upper eyelid swelling. There was no relative afferent pupillary defect, and the intraocular pressure was within the normal range. A provisional diagnosis of NTSOH was made. Conservative management was pursued, as there were no clinical signs of orbital compartment syndrome. However, the patient died 24 hours later following a recurrent cardiac arrest secondary to myocardial infarction. In conclusion, NTSOH may occur following CPR, possibly associated with transient increases in intrathoracic pressures generated during chest compressions. It should be suspected in patients who develop new proptosis or periorbital swelling following CPR, prompting urgent ophthalmic assessment to identify sight-threatening complications and guide timely clinical management.
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BibTeX
@article{chong2026nontraumatic,
title = {{Non-Traumatic Subperiosteal Orbital Hematoma After Cardiopulmonary Resuscitation: A Case Report.}},
author = {Yong Yuin Chong and Jun Fai Yap and Sylves Patrick and Joan Marie Palikat},
journal = {International medical case reports journal},
year = {2026},
month = oct,
doi = {10.2147/imcrj.s650173},
url = {https://europepmc.org/article/MED/42968968},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Non-Traumatic Subperiosteal Orbital Hematoma After Cardiopulmonary Resuscitation: A Case Report.
AU - Yong Yuin Chong
AU - Jun Fai Yap
AU - Sylves Patrick
AU - Joan Marie Palikat
PY - 2026
DA - 2026/10/28
JO - International medical case reports journal
DO - 10.2147/imcrj.s650173
UR - https://europepmc.org/article/MED/42968968
AB - Subperiosteal orbital hemorrhage is a rare condition that is typically observed following direct facial or orbital trauma. Non-traumatic subperiosteal orbital hemorrhage (NTSOH) has been infrequently reported in association with sudden elevations in cranial venous pressure or venous congestion. To the best of our knowledge, this is the first reported case of NTSOH associated with cardiopulmonary resuscitation (CPR). A 48-year-old woman with end-stage renal disease developed cardiac arrest while undergoing hemodialysis. CPR was performed for 24 minutes, resulting in the successful return of spontaneous circulation. Contrast-enhanced computed tomography of the brain incidentally revealed a 2.6 × 2.4 × 1.2 cm mixed-density subperiosteal lesion along the roof of the right orbit with a smooth lateral margin, causing inferior displacement of the superior rectus muscle, consistent with an acute subperiosteal hematoma. The patient's coagulation profile and full blood count were within normal limits. Ophthalmic examination demonstrated mild right-sided proptosis and upper eyelid swelling. There was no relative afferent pupillary defect, and the intraocular pressure was within the normal range. A provisional diagnosis of NTSOH was made. Conservative management was pursued, as there were no clinical signs of orbital compartment syndrome. However, the patient died 24 hours later following a recurrent cardiac arrest secondary to myocardial infarction. In conclusion, NTSOH may occur following CPR, possibly associated with transient increases in intrathoracic pressures generated during chest compressions. It should be suspected in patients who develop new proptosis or periorbital swelling following CPR, prompting urgent ophthalmic assessment to identify sight-threatening complications and guide timely clinical management.
SN - 1179-142X
ER -