Basilar Skull Fracture
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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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Emergency Medicine
Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unscheduled and undifferentiated patients of all ages. As first-line providers, in coordination with Emergency Medical Services, they are primarily responsible for initiating resuscitation and stabilization and performing the initial investigations and interventions necessary to diagnose and treat illnesses or injuries in the acute phase. Emergency physicians generally practise in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics. Sub-specializations of emergency medicine include; disaster medicine, medical toxicology, point-of-care ultrasonography, critical care medicine, emergency medical services, hy ...
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Cranial Nerve
Cranial nerves are the nerves that emerge directly from the brain (including the brainstem), of which there are conventionally considered twelve pairs. Cranial nerves relay information between the brain and parts of the body, primarily to and from regions of the head and neck, including the special senses of vision, taste, smell, and hearing. The cranial nerves emerge from the central nervous system above the level of the first vertebra of the vertebral column. Each cranial nerve is paired and is present on both sides. There are conventionally twelve pairs of cranial nerves, which are described with Roman numerals I–XII. Some considered there to be thirteen pairs of cranial nerves, including cranial nerve zero. The numbering of the cranial nerves is based on the order in which they emerge from the brain and brainstem, from front to back. The terminal nerves (0), olfactory nerves (I) and optic nerves (II) emerge from the cerebrum, and the remaining ten pairs arise from t ...
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Ecchymosis
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. Bruises are not to be confused with other similar-looking lesions. (Such lesions include petechia (less than , resulting from numerous and diverse etiologies such as adverse reactions from medications such as warfarin, straining, asphyxiation, platelet disorders and diseases such as ''cytomegalovirus''), purpura (, classified as palpable purpura or non-palpable purpura and indicates various pathologic conditions such as thromb ...
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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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Bilateral Periorbital Ecchymosis (raccoon Eyes)
Bilateral may refer to any concept including two sides, in particular: *Bilateria, bilateral animals *Bilateralism, the political and cultural relations between two states *Bilateral, occurring on both sides of an organism ( Anatomical terms of location § Medial and lateral) *Bilateral symmetry, symmetry between two sides of an organism *Bilateral filter, an image processing algorithm * Bilateral amplifier, a type of amplifier * ''Bilateral'' (album), an album by the band ''Leprous'' *Bilateral school, see Partially selective school (England) In England, a partially selective school is one of a few dozen state-funded secondary schools that select a proportion of their intake by ability or aptitude, permitted as a continuation of arrangements that existed prior to 1997. Though treated ...
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Head Injury
A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injuries, there are many causes—including accidents, falls, physical assault, or traffic accidents—that can cause head injuries. The number of new cases is 1.7 million in the United States each year, with about 3% of these incidents leading to death. Adults have head injuries more frequently than any age group resulting from falls, motor vehicle crashes, colliding or being struck by an object, or assaults. Children, however, may experience head injuries from accidental falls or intentional causes (such as being struck or shaken) leading to hospitalization. Acquired brain injury (ABI) is a term used to differentiate brain injuries occurring after birth from injury, from a genetic disorder, or from a congenital disorder. Unlike a broken bon ...
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Facial Fractures
Facial trauma, also called maxillofacial trauma, is any physical trauma to the face. Facial trauma can involve soft tissue injuries such as burns, lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures of the jaw, as well as trauma such as eye injuries. Symptoms are specific to the type of injury; for example, fractures may involve pain, swelling, loss of function, or changes in the shape of facial structures. Facial injuries have the potential to cause disfigurement and loss of function; for example, blindness or difficulty moving the jaw can result. Although it is seldom life-threatening, facial trauma can also be deadly, because it can cause severe bleeding or interference with the airway; thus a primary concern in treatment is ensuring that the airway is open and not threatened so that the patient can breathe. Depending on the type of facial injury, treatment may include bandaging and suturing of open wounds, administration of i ...
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Posterior Cranial Fossa
The posterior cranial fossa is part of the cranial cavity, located between the foramen magnum and tentorium cerebelli. It contains the brainstem and cerebellum. This is the most inferior of the fossae. It houses the cerebellum, medulla and pons. Anteriorly it extends to the apex of the petrous temporal. Posteriorly it is enclosed by the occipital bone. Laterally portions of the squamous temporal and mastoid part of the temporal bone form its walls. Features Foramen magnum The most conspicuous, large opening in the floor of the fossa. It transmits the medulla, the ascending portions of the spinal accessory nerve (XI), and the vertebral arteries. Internal acoustic meatus Lies in the anterior wall of the posterior cranial fossa. It transmits the facial (VII) and vestibulocochlear (VIII) cranial nerves into a canal in the petrous temporal bone. Jugular foramen Lies between the inferior edge of the petrous temporal bone and the adjacent occipital bone and transmits the internal ...
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Middle 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 present ...
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Anterior Fossa
The anterior cranial fossa is a depression in the floor of the cranial base which houses the projecting frontal lobes of the brain. It is formed by the orbital plates of the frontal, the cribriform plate of the ethmoid, and the small wings and front part of the body of the sphenoid; it is limited behind by the posterior borders of the small wings of the sphenoid and by the anterior margin of the chiasmatic groove. The lesser wings of the sphenoid separate the anterior and middle fossae. Structure It is traversed by the frontoethmoidal, sphenoethmoidal, and sphenofrontal sutures. Its lateral portions roof in the orbital cavities and support the frontal lobes of the cerebrum; they are convex and marked by depressions for the brain convolutions, and grooves for branches of the meningeal vessels. The central portion corresponds with the roof of the nasal cavity, and is markedly depressed on either side of the crista galli. It presents, in and near the median line, from before ba ...
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Ethmoid Bone
The ethmoid bone (; from grc, ἡθμός, hēthmós, sieve) is an unpaired bone in the skull that separates the nasal cavity from the brain. It is located at the roof of the nose, between the two orbits. The cubical bone is lightweight due to a spongy construction. The ethmoid bone is one of the bones that make up the orbit of the eye. Structure The ethmoid bone is an anterior cranial bone located between the eyes. It contributes to the medial wall of the orbit, the nasal cavity, and the nasal septum. The ethmoid has three parts: cribriform plate, ethmoidal labyrinth, and perpendicular plate. The cribriform plate forms the roof of the nasal cavity and also contributes to formation of the anterior cranial fossa, the ethmoidal labyrinth consists of a large mass on either side of the perpendicular plate, and the perpendicular plate forms the superior two-thirds of the nasal septum. Between the orbital plate and the nasal conchae are the ethmoidal sinuses or ethmoidal air cells, w ...
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Frontal Bone
The frontal bone is a bone in the human skull. The bone consists of two portions.''Gray's Anatomy'' (1918) These are the vertically oriented squamous part, and the horizontally oriented orbital part, making up the bony part of the forehead, part of the bony orbital cavity holding the eye, and part of the bony part of the nose respectively. The name comes from the Latin word ''frons'' (meaning " forehead"). Structure of the frontal bone The frontal bone is made up of two main parts. These are the squamous part, and the orbital part. The squamous part marks the vertical, flat, and also the biggest part, and the main region of the forehead. The orbital part is the horizontal and second biggest region of the frontal bone. It enters into the formation of the roofs of the orbital and nasal cavities. Sometimes a third part is included as the nasal part of the frontal bone, and sometimes this is included with the squamous part. The nasal part is between the brow ridges, and ends in ...
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