Craniofacial injuries can occur in a significant proportion in traumatic brain injury patients and can be associated with many other concomitant life-threatening systemic injuries i.e. limbs fractures, chest injuries, spinal injuries and orbital injuries. An understanding of the presentations of craniofacial injuries, associated systemic injuries and patterns of traumatic brain injuries is crucial for improving care, survival and recovery of these patients. In present article we discuss the approach to craniofacial injuries which is based on time tested principles of surgery a good understanding of surgical anatomy, detailed history, accurate yet elaborative clinical evaluation, appropriate radiological investigations and decision to select management protocol for a given case. Evaluation of these patients should include a coordinated and systematic examination to aim to evaluate of all areas and all the residents while examining these patients in emergency room should remember that facial swelling, altered sensorium, restless patient, presence of endotracheal and nasogastric tube can obscure the detail examination and distort the facial appearance.

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We report the clinical details, imaging findings, and management for a 39-year-old female presenting with recurrent episodes of pain in abdomen due to systemic lupus erythematous vasculitis associated with spontaneous isolated inferior mesenteric dissection. Spontaneous mesenteric artery dissection is an uncommon cause of mesenteric ischemia. Symptomatic spontaneous isolated inferior mesenteric artery (IMA) dissection is a rare condition, and its association with systemic lupus erythematosus is not previously described in the English literature. The optimal treatment options are debatable and include medical management, surgical reconstruction, and endovascular therapy. We wish to highlight spontaneous isolated IMA dissection as a rare etiology for chronic mesenteric ischemia and its management by endovascular methods.

Hydatid disease is an endemic parasitic disease and can occur anywhere in the body and has a variable presentation. On imaging, the lesions have varied appearance ranging from cystic to solid appearing lesions, solitary to multiples. We present a case of 35-year-old female who underwent decompression craniectomy for right temporoparietal hemorrhagic venous infarct and now presented with acute onset of right-sided weakness. Magnetic resonance imaging was suggestive of cerebral hydatid disease. The presented case emphasizes that hydatid cyst should be considered as a possibility whenever a cystic lesion is encountered during imaging.