Basilar Skull Fracture

a fracture of the base of the skull, typically involving the temporal, occipital, sphenoid and ethmoid bones of the skull.

Such fractures can cause tears in the cerebral meninges, with resultant leakage of the cerebrospinal (CSF) and hematoma formation.

Manifestations:

  • otorrhea – leakage of CSF from the auditory canal
  • rhinorrhea – leakage of CSF from the nasal passages
  • hematoma presentation surrounding the orbits and ears as blood is flushed to the surface of the facial tissues.
  • Battle’s sign is bruising over the mastoid sinus (just behind the auricle) and is a delayed physical finding associated with basilar skull fractures.
  • Hemotympanum (blood behind the ear drum) and “raccoon eyes” (periorbital bruising) are other delayed findings consistent with basilar skull fractures.”

Patients are prone to meningitis due to CSF leakage and meningeal trauma increasing the microbial portal of entry and menigeal integrity.

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