Diferencia entre revisiones de «Basilar skull fracture»
(Created page with "==Background== *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....") |
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==Background== | ==Background== | ||
* | *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 | ||
**orbital plate of the frontal bone | **orbital plate of the frontal bone | ||
**petrous and squamous portion of the temporal bone | **petrous and squamous portion of the temporal bone | ||
**sphenoid and occipital bones | **sphenoid and occipital bones | ||
* | *Occur most commonly through temporal bone--> high risk for extra-axial hematomas, particularly [[epidural hematoma]] | ||
==Clinical Features== | ==Clinical Features== | ||
*Nausea | *[[Nausea/vomiting]], oculomotor deficits from [[cranial nerve palsies|injuries]] to CN3, 4 or 6 | ||
*Retroauricular or mastoid ecchymosis (Battle sign), | *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 | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Any other type of [[skull fracture]] | *Any other type of [[skull fracture]] | ||
*Intracranial injury | |||
==Evaluation== | ==Evaluation== | ||
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==Management== | ==Management== | ||
* | *Immediate neurosurgical consultation | ||
==Disposition== | ==Disposition== | ||
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<references/> | <references/> | ||
[[Category: | [[Category:Trauma]] | ||
Revisión del 00:35 20 ago 2019
Background
- 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
- 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
- Any other type of skull fracture
- Intracranial injury
Evaluation
- Noncontrast CT head
Management
- Immediate neurosurgical consultation
Disposition
- Admit for observation regardless of need for surgical intervention
See Also
References
- ↑ 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