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==Background==
==Background==
[[File:Cranial bones en.png|thumb|Bones of the cranium.]]
*Involve at least one of five bones that comprise base of the skull <ref> Golfinos JG, Cooper PR. Skull fracture and post-traumatic cerebrospinal fluid fistula. In:Head Injury, 4th, Cooper PR, Golfinos JG (Eds), McGraw-Hill, New York 2000. p.155 </ref>
*Involve at least one of five bones that comprise base of the skull <ref> Golfinos JG, Cooper PR. Skull fracture and post-traumatic cerebrospinal fluid fistula. In:Head Injury, 4th, Cooper PR, Golfinos JG (Eds), McGraw-Hill, New York 2000. p.155 </ref>
**cribriform plate of ethmoid bone
**cribriform plate of ethmoid bone
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*Retroauricular or mastoid ecchymosis (Battle sign), onset 1-3 days after fracture occurred
*Retroauricular or mastoid ecchymosis (Battle sign), onset 1-3 days after fracture occurred
*Raccoon eyes: periorbital ecchymosis
*Raccoon eyes: periorbital ecchymosis
*Clear rhinorrhea or otorrhea
*Clear [[rhinorrhea]] or otorrhea
**"halo" sign: drop of fluid placed on tissue or filter paper, rapidly expanding ring of clear fluid around red blood defines positive test
**"halo" sign: drop of fluid placed on tissue or filter paper, rapidly expanding ring of clear fluid around red blood defines positive test
**CSF distinguished from local nasal secretions with presence of beta-trace protein or beta-2 transferrin
**CSF distinguished from local nasal secretions with presence of beta-trace protein or beta-2 transferrin
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==Evaluation==
==Evaluation==
[[File:Tempbonefract.png|thumb|Temporal bone fracture as seen on CT.]]
[[File:BasSkullFracMark.png|thumb|CT showing basilar skull fracture]]
*Noncontrast CT head
*Noncontrast CT head


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==See Also==
==See Also==
*[[Skull Fracture]]
*[[Skull Fracture]]
==External Links==
*Pillai, Saran S. Basilar Skull Fracture: Basics & Beyond available at http://www.emdocs.net/basilar-skull-fracture-basics-beyond/


==References==
==References==

Revisión actual - 17:15 31 dic 2019

Background

Bones of the cranium.
  • Involve at least one of five bones that comprise base of the skull [1]
    • cribriform plate of ethmoid bone
    • orbital plate of the frontal bone
    • petrous and squamous portion of the temporal bone
    • sphenoid and occipital bones
  • Occur most commonly through temporal bone--> high risk for extra-axial hematomas, particularly epidural hematoma

Clinical Features

Raccoon eyes
  • Nausea/vomiting, oculomotor deficits from injuries to CN3, 4 or 6
  • Retroauricular or mastoid ecchymosis (Battle sign), onset 1-3 days after fracture occurred
  • Raccoon eyes: periorbital ecchymosis
  • Clear rhinorrhea or otorrhea
    • "halo" sign: drop of fluid placed on tissue or filter paper, rapidly expanding ring of clear fluid around red blood defines positive test
    • CSF distinguished from local nasal secretions with presence of beta-trace protein or beta-2 transferrin
  • Hemotympanum

Differential Diagnosis

Head trauma

Maxillofacial Trauma

Evaluation

Temporal bone fracture as seen on CT.
CT showing basilar skull fracture
  • Noncontrast CT head

Management

  • Immediate neurosurgical consultation

Disposition

  • Admit for observation regardless of need for surgical intervention

See Also

External Links

References

  1. ↑ Golfinos JG, Cooper PR. Skull fracture and post-traumatic cerebrospinal fluid fistula. In:Head Injury, 4th, Cooper PR, Golfinos JG (Eds), McGraw-Hill, New York 2000. p.155
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