Basal Skull Fracture vs. Soft Tissue Contusion
Left picture: The subconjunctival hemorrhage militates for a deeply situated injury, e.g. a basal skull fracture. Right picture: Here, a simple contusion of the soft tissue is likely. In both patients a fracture of the orbita (e.g. in case of motility disturbance of the eye or the confirmation of a fracture by special x-ray) and a contusion of the bulb (ophthalmological examination) must be excluded.
Both schoolchildren have sustained a trauma and exhibit a monocular hematoma. Left picture: In this patient the subconjunctival temporal bleeding of the right eye stands in the foreground, not the monocular hematoma of the same side. Right picture: Here, no subconjunctival hemorrhage is visible; the monocular hematoma of the left side of the face is more impressive. The differential diagnosis includes a superficial soft tissue contusion, a contusion of the bulb, a fracture of the orbita, or a basal skull fracture.