Intradiploic hematoma of the frontal bone with secondary exophthalmos in a mare.

The research article details a rare case where a 13-year-old mare developed an intradiploic hematoma, a blood clot within the frontal bone of the skull, following a head injury. This condition led to exophthalmos, or protrusion of the eye, which was diagnosed using advanced imaging techniques and confirmed via surgery.

Introduction and Case Presentation

• The mare experienced head trauma five years prior to the diagnosis of intradiploic hematoma.
• The only clinical symptom was exophthalmos, a condition where the eye protrudes abnormally out of the socket, along with deformation of the facial bone.
• Increased swelling and deformation around the left eye of the mare was initially observed, leading to further diagnostics.

Diagnostic Approach

• Tests conducted included an ocular ultrasound, a sonographic examination through the thinned frontal bone, radiography, and standing computed tomography (CT) of the skull.
• Standing CT was particularly useful for differentiating the severity and cause of the mare’s facial bone distortion from other, more common causes related to paranasal sinus diseases.
• The identification of the intradiploic hematoma was achieved through these techniques, highlighting the potency of these approaches for accurate diagnosis.

Surgery and Histopathology

• An exploratory osteoplastic surgery, involving the repositioning of bone for repairing the damaged or deformed areas, was carried out.
• A histopathology study was completed, which involves examining tissues under a microscope to study the manifestations of the disease.
• The results revealed the presence of an organized hematoma, confirming that an intradiploic hematoma was indeed the cause of the exophthalmos.

Conclusion and Clinical Significance

• This is a rare case showcasing intradiploic hematoma as the cause of facial bone deformation and exophthalmos in horses, with a possible traumatic origin.
• These results indicate that intradiploic hematoma should be considered as a differential diagnosis for sinonasal disease and exophthalmos in horses.
• This case strongly advocates the use of advanced imaging techniques like standing CT scans in diagnosis.