Trauma to the head can result in formation of an orbital arteriovenous malformation or pseudoaneurysm.
Mechanism: an artery and vein in close proximity may develop a fistula following vascular trauma. Shearing force on an artery can result in a pseudoaneurysm.
Clinical features:
(1) history of head trauma, especially involving the face
(2) delayed onset of orbital symptoms such as proptosis
(3) presence of an orbital bruit
The diagnosis can be confirmed by angiography.
Significance:
(1) The presence of a traumatic orbital AVM may be associated with occult traumatic cerebrovascular injuries elsewhere.
(2) A traumatic AVM or pseudoaneurysm can rupture, giving rise to significant hemorrhage.
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