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Basilar skull fracture
| Basilar skull fracture | |
|---|---|
| Other names | Basal skull fracture, skull base fractures[1] |
 | |
| A subtle temporal bone fracture as seen on a CT scan | |
| Specialty | Emergency medicine, neurosurgery |
| Symptoms | Bruising behind the ears, bruising around the eyes, blood behind the ear drum[1] |
| Complications | Cerebrospinal fluid leak, facial fracture, meningitis[2][1] |
| Types | Anterior, central, posterior[1] |
| Causes | Trauma[1] |
| Diagnostic method | CT scan[1] |
| Treatment | Based on injuries inside the skull[1] |
| Frequency | ≈12% of severe head injuries[1] |
A basilar skull fracture is a break of a bone in the base of the skull.[1] Symptoms may include bruising behind the ears, bruising around the eyes, or blood behind the ear drum.[1] A cerebrospinal fluid (CSF) leak occurs in about 20% of cases and may result in fluid leaking from the nose or ear.[1] Meningitis occurs in about 14% of cases.[2] Other complications include injuries to the cranial nerves or blood vessels.[1]
A basilar skull fracture typically requires a significant degree of trauma to occur.[1] It is defined as a fracture of one or more of the temporal, occipital, sphenoid, frontal or ethmoid bone.[1] Basilar skull fractures are divided into anterior fossa, middle fossa and posterior fossa fractures.[1] Facial fractures often also occur.[1] Diagnosis is typically by CT scan.[1]
Treatment is generally based on the extent and location of the injury to structures inside the head.[1] Surgery may be performed to seal a CSF leak that does not stop, to relieve pressure on a cranial nerve or repair injury to a blood vessel.[1] Prophylactic antibiotics do not provide a clinical benefit in preventing meningitis.[2][3] A basilar skull fracture occurs in about 12% of people with a severe head injury.[1]
- ^ a b c d e f g h i j k l m n o p q r s t Baugnon, KL; Hudgins, PA (August 2014). "Skull base fractures and their complications". Neuroimaging Clinics of North America. 24 (3): 439–65, vii–viii. doi:10.1016/j.nic.2014.03.001. PMID 25086806.
- ^ a b c Nellis, JC; Kesser, BW; Park, SS (January 2014). "What is the efficacy of prophylactic antibiotics in basilar skull fractures?". The Laryngoscope. 124 (1): 8–9. doi:10.1002/lary.23934. PMID 24122671.
- ^ Ratilal, Bernardo O; Costa, João; Pappamikail, Lia; Sampaio, Cristina; Ratilal, Bernardo O (2015). "Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures". The Cochrane Database of Systematic Reviews. 2015 (4): CD004884. doi:10.1002/14651858.CD004884.pub4. PMC 10554555. PMID 25918919.
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