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Introduction to CNS Imaging, Trauma

(Left) Coronal graphic shows 3

lines defining the 3 classic

types of Le Fort fractures. Le

Fort I (green) involves the

maxilla and nasal aperture. Le

Fort II (red), a.k.a. pyramidal

fracture, extends upward

across the maxilla and across

the inferior orbital rim and

nose. Le Fort III (black), a.k.a.

craniofacial separation,

extends through the orbits and

zygomatic arches. (Right) 3D

CT shows a Le Fort I fracture

﬇ through the maxillary

alveolus and nose.

(Left) Sagittal reformatted

bone CT shows a Le Fort I

fracture extending from

maxillary alveolus ſt into the

posterior sinus wall and

pterygoid plate st. (Right) 3D

CT shows a Le Fort II fracture

through the nasofrontal

junction st that descends

obliquely through the inferior

orbital rim ﬈. A Le Fort I

fracture ﬇ is also present

through the maxillary alveolus

and nose. A nondisplaced

mandibular fracture ﬉ is also

present. It is common to have

multiple types of facial

fractures in the same patient.

(Left) 3D CT shows a Le Fort III

fracture with frontonasal

diastasis ﬇, orbital wall

fracture ﬉, and diastasis of

the zygomaticofrontal suture

﬈. (Right) Axial bone CT in a

complex midface "smash"

injury shows comminuted,

depressed nasal bone and

ethmoid fractures ſt,

maxillary sinus fractures ﬇,

and zygoma fractures st.

Brain: Pathology-Based Diagnoses: Malformations,

Trauma, and Stroke

36

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