The hazard of cycles with front suspension
Jeff Downie
(With thanks to Surgeons' News, January 2004)
A 61-year-old female purchased a new bicycle with front suspension forks and disc brakes. Whilst travelling downhill at some speed, she met a car coming in the opposite direction. She applied the front brake and the bicycle responded by dipping and throwing her over the handlebars. She struck her face on the road and was rendered unconscious for several minutes. On arrival at Accident and Emergency she complained of double vision and numbness over her left cheek. At this point a referral was made to Maxillofacial Surgery and Ophthalmology.
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| What does this CT scan show (Fig. 1)? | Click here for answer |
| Why does she have a numb cheek? | Click here for answer |
| What eye signs would be present? | Click here for answer |
| Why does she have diplopia? | Click here for answer |
| Is her diplopia likely to be monocular or binocular? | Click here for answer |
| What surgical intervention is required? | Click here for answer |
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She subsequently developed proptosis and reduced visual acuity with intense pain behind her eye. |
Click here for answer |
| How would you manage this? | Click here for answer |