Basilar skull fracture

A basilar skull fracture is a break of a bone in the base of the skull. Symptoms may include bruising behind the ears, bruising around the eyes, or blood behind the ear drum. A cerebrospinal fluid (CSF) leak occurs in about 20% of cases and may result in fluid leaking from the nose or ear. Meningitis occurs in about 14% of cases. Other complications include injuries to the cranial nerves or blood vessels. A basilar skull fracture typically requires a significant degree of trauma to occur. It is defined as a fracture of one or more of the temporal, occipital, sphenoid, frontal or ethmoid bone. Basilar skull fractures are divided into anterior fossa, middle fossa and posterior fossa fractures. Facial fractures often also occur. Diagnosis is typically by CT scan. Treatment is generally based on the extent and location of the injury to structures inside the head. 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. Prophylactic antibiotics do not provide a clinical benefit in preventing meningitis. A basilar skull fracture occurs in about 12% of people with a severe head injury. Battle's sign – bruising of the mastoid process of the temporal bone. Raccoon eyes – bruising around the eyes, i.e. "black eyes" Cerebrospinal fluid rhinorrhea Cranial nerve palsy Bleeding (sometimes profuse) from the nose and ears Hemotympanum Conductive or perceptive deafness, nystagmus, vomiting In 1–10% of patients, optic nerve entrapment occurs. The optic nerve is compressed by the broken skull bones, causing irregularities in vision. Serious cases usually result in death Basilar skull fractures include breaks in the posterior skull base or anterior skull base. The former involve the occipital bone, temporal bone, and portions of the sphenoid bone; the latter, superior portions of the sphenoid and ethmoid bones. The temporal bone fracture is encountered in 75% of all basilar skull fractures and may be longitudinal, transverse or mixed, depending on the course of the fracture line in relation to the longitudinal axis of the pyramid.

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Méningite

La est une maladie caractérisée par une inflammation des méninges, les enveloppes du névraxe (encéphale et moelle spinale). Cette inflammation peut être due à une infection par un virus ou une bactérie par exemple, et moins souvent par un médicament. La méningite peut menacer le pronostic vital en raison de la proximité immédiate de l'encéphale ; il s'agit d'une urgence. C'est essentiellement le fait des méningites bactériennes, plus rares, tandis que les méningites virales, plus fréquentes, sont en principe bénignes.

Skull fracture

A skull fracture is a break in one or more of the eight bones that form the cranial portion of the skull, usually occurring as a result of blunt force trauma. If the force of the impact is excessive, the bone may fracture at or near the site of the impact and cause damage to the underlying structures within the skull such as the membranes, blood vessels, and brain.

Bruise

A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur close enough to the epidermis such that the bleeding causes a visible discoloration. The bruise then remains visible until the blood is either absorbed by tissues or cleared by immune system action. Bruises which do not blanch under pressure can involve capillaries at the level of skin, subcutaneous tissue, muscle, or bone.

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