Basilar skull fracture | |
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Other names | Basal skull fracture, skull base fractures[1] |
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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]