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NEUROIMAGES
Year : 2019  |  Volume : 67  |  Issue : 4  |  Page : 1166

Bare Orbit Sign/Empty Orbit Sign – Is It Really Empty?


Department of Radiodiagnosis, Katuri Medical College, Guntur, Andhra Pradesh, India

Date of Web Publication10-Sep-2019

Correspondence Address:
Dr. Ramakrishna Narra
Flat No: 30, 5 Floor,Venkatesh Estate Apartment, ½ Chandramouli Nagar, Guntur - 522 006, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.266298

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How to cite this article:
Narra R, Kamaraju SK, Putcha A. Bare Orbit Sign/Empty Orbit Sign – Is It Really Empty?. Neurol India 2019;67:1166

How to cite this URL:
Narra R, Kamaraju SK, Putcha A. Bare Orbit Sign/Empty Orbit Sign – Is It Really Empty?. Neurol India [serial online] 2019 [cited 2019 Nov 13];67:1166. Available from: http://www.neurologyindia.com/text.asp?2019/67/4/1166/266298




A 30-year-old female patient came to our outpatient department with chief complaints of chest pain and shortness of breath for the previous one month. On examination, proptosis of left eye with pulsating exophthalmos and café-au-lait spots on the skin were present. A CT scan of the chest revealed, a right paravertebral posterior mediastinal mass was present. On the AP view of the skull, the innominate line was absent in the left orbit. A CT scan of the brain revealed, dysplasia of left sphenoid wing was noted with mild herniation of left temporal lobe and meninges toward the orbit [Figure 1]d.
Figure 1: (a) Graphical representation showing bones forming orbit: yellow = frontal bone, green = lacrimal bone, pink = ethmoid bone, blue = zygomatic bone, orange = maxillary bone, red = sphenoid bone, aqua = palatine bone. Note a bony defect in posterior aspect of left orbit due to the absence of left sphenoid wing giving the “Empty orbit sign.” (b) Plain radiograph AP view. (c) CT surface shaded display image. (d) Axial CT scan demonstrating orbits

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Based on the above findings, the patient was diagnosed with Neurofibromatosis type I.

Innominate line is a landmark formed by the projection of greater wing of sphenoid, seen in orbit on a frontal x-ray of skull [Figure 1]b.[1],[2]

In Neurofibromatosis type I, the bare orbit sign or empty orbit sign is a characteristic finding which does not mean that the orbit is actually empty, but actually represents the absence of the innominate line on imaging, seen due to sphenoid wing dysplasia [Figure 1]a and [Figure 1]c.[3],[4]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bertelli E, Regoli M. Branching of the foramen rotundum. A rare variation of the sphenoid. Ital J Anat Embryol 2014;119:148-53.  Back to cited text no. 1
    
2.
Moore KL. Clinically Oriented Anatomy. 6th ed. Lippincott Williams and Wilkins; 2010.  Back to cited text no. 2
    
3.
Cranio-orbital-temporal neurofibromatosis: A case report and review of literature. 2004;14:317-9.  Back to cited text no. 3
    
4.
Chavhan GB, Shroff MM. Twenty classic signs in neuroradiology: A pictorial essay. Indian J Radiol Imaging 2009;19:135-45.  Back to cited text no. 4
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