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Battle's Sign
Battle's sign, also known as mastoid ecchymosis, is an indication of fracture of middle cranial fossa of the skull. These fractures may be associated with underlying brain trauma. Battle's sign consists of bruising over the mastoid process as a result of extravasation of blood along the path of the posterior auricular artery. The sign is named after William Henry Battle. Battle's sign takes at least one day to appear after the initial traumatic basilar skull fracture, similar to raccoon eyes. It is usually seen after head injuries resulting in injury to mastoid process leading to bruising. Battle's sign may be confused with a spreading hematoma from a fracture of the mandibular condyle, which is a less serious injury. See also *Basilar skull fracture *Raccoon eyes *Black eye A periorbital hematoma, commonly called a black eye or a shiner (associated with boxing or stick sports such as hockey), is bruising around the eye commonly due to an injury to the face rather than ...
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Bone Fracture
A bone fracture (abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. In more severe cases, the bone may be broken into several fragments, known as a ''comminuted fracture''. A bone fracture may be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture. Signs and symptoms Although bone tissue contains no pain receptors, a bone fracture is painful for several reasons: * Breaking in the continuity of the periosteum, with or without similar discontinuity in endosteum, as both contain multiple pain receptors. * Edema and hematoma of nearby soft tissues caused by ruptured bone marrow evokes pressure pain. * Involuntary muscle spasms trying to hold bone fragments in place. D ...
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Middle Cranial Fossa
The middle cranial fossa, deeper than the anterior cranial fossa, is narrow medially and widens laterally to the sides of the skull. It is separated from the posterior fossa by the clivus and the petrous crest. It is bounded in front by the posterior margins of the lesser wings of the sphenoid bone, the anterior clinoid processes, and the ridge forming the anterior margin of the chiasmatic groove; behind, by the superior angles of the petrous portions of the temporal bones and the dorsum sellæ; laterally by the temporal squamæ, sphenoidal angles of the parietals, and greater wings of the sphenoid. It is traversed by the squamosal, sphenoparietal, sphenosquamosal, and sphenopetrosal sutures. It houses the temporal lobes of the brain and the pituitary gland. A middle fossa craniotomy is one means to surgically remove acoustic neuromas (vestibular schwannoma) growing within the internal auditory canal of the temporal bone. Middle part The middle part of the fossa presents, i ...
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Human Skull
The skull is a bone protective cavity for the brain. The skull is composed of four types of bone i.e., cranial bones, facial bones, ear ossicles and hyoid bone. However two parts are more prominent: the cranium and the mandible. In humans, these two parts are the neurocranium and the viscerocranium ( facial skeleton) that includes the mandible as its largest bone. The skull forms the anterior-most portion of the skeleton and is a product of cephalisation—housing the brain, and several sensory structures such as the eyes, ears, nose, and mouth. In humans these sensory structures are part of the facial skeleton. Functions of the skull include protection of the brain, fixing the distance between the eyes to allow stereoscopic vision, and fixing the position of the ears to enable sound localisation of the direction and distance of sounds. In some animals, such as horned ungulates (mammals with hooves), the skull also has a defensive function by providing the mount (on the front ...
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Traumatic Brain Injury
A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic brain injury), mechanism ( closed or penetrating head injury), or other features (e.g., occurring in a specific location or over a widespread area). Head injury is a broader category that may involve damage to other structures such as the scalp and skull. TBI can result in physical, cognitive, social, emotional and behavioral symptoms, and outcomes can range from complete recovery to permanent disability or death. Causes include falls, vehicle collisions and violence. Brain trauma occurs as a consequence of a sudden acceleration or deceleration within the cranium or by a complex combination of both movement and sudden impact. In addition to the damage caused at the moment of injury, a variety of events following the injury may result in ...
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Mastoid Process
The mastoid part of the temporal bone is the posterior (back) part of the temporal bone, one of the bones of the skull. Its rough surface gives attachment to various muscles (via tendons) and it has openings for blood vessels. From its borders, the mastoid part articulates with two other bones. Etymology The word "mastoid" is derived from the Greek word for "breast", a reference to the shape of this bone. Surfaces Outer surface Its outer surface is rough and gives attachment to the occipitalis and posterior auricular muscles. It is perforated by numerous foramina (holes); for example, the mastoid foramen is situated near the posterior border and transmits a vein to the transverse sinus and a small branch of the occipital artery to the dura mater. The position and size of this foramen are very variable; it is not always present; sometimes it is situated in the occipital bone, or in the suture between the temporal and the occipital. Mastoid process The mastoid process is ...
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Extravasation
__NOTOC__ Extravasation is the leakage of a fluid out of its container into the surrounding area, especially blood or blood cells from vessels. In the case of inflammation, it refers to the movement of white blood cells from the capillaries to the tissues surrounding them (leukocyte extravasation, also known as ''diapedesis''). In the case of malignant cancer metastasis it refers to cancer cells exiting the capillaries and entering organs (to form secondary tumors). It is frequently used in medical contexts, either referring to urine, or to blood. More specifically, it can refer to: * Extravasation (intravenous) * Extravasation of infusates * Extravasation of irrigation fluid * Extravasation of urine * Leukocyte extravasation * Angiopellosis (non-leukocyte cell extravastion) Extravasation of irrigation fluid Extravasation of irrigation fluid is the unintended migration of irrigation fluid (e.g. saline) introduced into a human body. This may occur in a number of types of endoscop ...
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Posterior Auricular Artery
The posterior auricular artery is a small artery that arises from the external carotid artery, above the digastric muscle and stylohyoid muscle, opposite the apex of the styloid process. It ascends posteriorly beneath the parotid gland, along the styloid process of the temporal bone, between the cartilage of the ear and the mastoid process of the temporal bone along the lateral side of the head. The posterior auricular artery gives off the stylomastoid artery, small branches to the auricle, and supplies blood to the scalp posterior to the auricle. A person may be able to "hear" their own heart rate via this artery, under certain conditions. See also * Anterior auricular branches of superficial temporal artery The anterior auricular branches of the superficial temporal artery are distributed to the anterior portion of the auricula, the lobule, and part of the external meatus, anastomosing with the posterior auricular. They supply the external acousti ... * Posterior auric ...
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William Henry Battle
William Henry Battle (23 February 1855 – 1936) was an English surgeon and teacher. Education William Henry Battle was born in Lincolnshire on 23 February 1855 and died in 1936. Starting in 1866, he attended Lincoln Christ's Hospital School and then Haileybury School, Hertfordshire. Battle went on to attend St. Thomas' Medical School in London, England starting in 1873. He graduated medical school with MRCS and LSA in 1877, and successfully obtained his FRCS in 1880 after serving his house jobs at St. Thomas' School. During his time in medical school, Battle was given the Solly Medal in the first year it was awarded. Professional endeavors Battle became a Fellow of the Royal Collehe of Surgeons in 1880. In the same year, he was appointed as a Surgical Registrar to St Thomas' Hospital. He joined the British Medical Association in 1886 and eventually became honorary secretary of the section of surgery. In 1888, Battle became assistant surgeon at East London Hospital for Chil ...
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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 repai ...
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Raccoon Eyes
Raccoon eyes (also known in the United Kingdom and Ireland as panda eyes) or periorbital ecchymosis is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain cancers. Bilateral hemorrhage occurs when damage at the time of a facial fracture tears the meninges and causes the venous sinuses to bleed into the arachnoid villi and the cranial sinuses. In lay terms, blood from skull fracture seeps into the soft tissue around the eyes. Raccoon eyes may be accompanied by Battle's sign, an ecchymosis behind the ear. These signs may be the only sign of a skull fracture, as it may not show on an X-ray. They normally appear between 48 and 72 hours after the injury. It is recommended that the patient not blow their nose, cough vigorously, or strain to prevent further tearing of the meninges. Raccoon eyes may be bilateral or unilateral. If unilateral, it is highly suggestive of basilar skull fracture, with a positive predictive value of 8 ...
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Hematoma
A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillary, capillaries. A hematoma is benign and is initially in liquid form spread among the tissues including in sacs between tissues where it may coagulate and solidify before blood is reabsorbed into blood vessels. An ecchymosis is a hematoma of the skin larger than 10 mm. They may occur among and or within many areas such as skin and other organs, connective tissues, bone, joints and muscle. A collection of blood (or even a hemorrhage) may be aggravated by anticoagulant medication (blood thinner). Blood seepage and collection of blood may occur if heparin is given via an Intramuscular injection, intramuscular route; to avoid this, heparin must be given intravenously or subcutaneous injection, subcutaneously. Signs and symptoms Some hematomas are visible ...
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Mandibular Fracture
Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel properly aligned or there may be bleeding of the gums. Mandibular fractures occur most commonly among males in their 30s. Mandibular fractures are typically the result of trauma. This can include a fall onto the chin or a hit from the side. Rarely they may be due to osteonecrosis or tumors in the bone. The most common area of fracture is at the condyle (36%), body (21%), angle (20%) and symphysis (14%). While a diagnosis can occasionally be made with plain X-ray, modern CT scans are more accurate. Immediate surgery is not necessarily required. Occasionally people may go home and follow up for surgery in the next few days. A number of surgical techniques may be used including maxillomandibular fixation and open reduction internal fixati ...
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