Orbital trauma, bradycardia, and vomiting: trapdoor fracture and the oculocardiac reflex: a case report.
The presentation of vomiting and bradycardia after closed head trauma should invariably prompt concern for significant intracranial injury, yet other less common causes for the clinical picture do exist. This case reports one such scenario in which fracture to the patient's inferior orbital wall resulted in the rare though potentially life-threatening oculocardiac reflex, a vagally mediated phenomenon with possible respiratory, cardiovascular, and gastric motility effects.
Division of Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA. jacksobf@musc.edu
Benjamin F
BF
Jackson
D000293:Adolescent; D001763:Blepharoptosis / Q000209:etiology; D001919:Bradycardia / Q000209:etiology*; D004172:Diplopia / Q000209:etiology*; D004630:Emergencies; D005538:Football / Q000293:injuries*; D006024:Glycopyrrolate / Q000494:pharmacology / Q000627:therapeutic use; D016489:Head Injuries, Closed / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D009801:Oculomotor Muscles / Q000187:drug effects / Q000293:injuries*; D009882:Ophthalmic Nerve / Q000503:physiopathology*; D009917:Orbital Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D010276:Parasympatholytics / Q000494:pharmacology / Q000627:therapeutic use; D012021:Reflex, Abnormal / Q000187:drug effects; D012024:Reflex, Oculocardiac / Q000187:drug effects / Q000502:physiology; D014057:Tomography, X-Ray Computed; D014474:Unconsciousness / Q000209:etiology; D014630:Vagus Nerve / Q000503:physiopathology; D014839:Vomiting / Q000209:etiology*
D010276:Parasympatholytics; D006024:Glycopyrrolate