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Basilar Skull Fracture

Afiesimama BOA - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Basilar Skull Fracture

History: 23 yo man who was involved in a physical altercation. The pt was struck in the back of the head and had his head smashed on a concrete sidewalk. The Pt lost consciousness for an unspecified amount of time. He was taken to a local hospital with a GCS of 9.

Findings: Head CT without contrast (best demonstrates the basilar scull fracture) There are fractures of both temporal bones seen. The right temporal bone demonstrates a 1.5 cm. horizontal fracture that is clearly seen in this section. There is also a longitudinal fracture of the petrous part of the left temporal bone—this one is not as easily seen; however it is best seen in this section. The most posterior fracture line is about 6mm in length. The most anterior fracture line is about 1 cm in length. These two fracture lines can be connected, in which case, it is easily seen that the fracture is interrupted by the mastoid air spaces and that it actually traverses the long axis of the left petrous temporal bone. It is also worth noting the fluid in the mastoid air spaces.

Ddx: Skull fracture Anatomic variant suture

Dxhow: Imaging

Exam: Physical exam at that time was significant for hematotympanum, CSF leakage, Battle's sign, hyperreflexic DTR's, and positive Babinski's. All cranial nerves were intact and there was no evidence of hearing loss. The pt demonstrated marked agitation, disinhibition (use of profanities) disorientation to time and place, urinary incontinence, dysarthria, and ataxia. The pt did well throughout his hospital course and was eventually discharged to a traumatic brain injury program.

No MeSH data available.


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Basilar Skull Fracture

Afiesimama BOA - MedPix (2007)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1310&req=5

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Basilar Skull Fracture

History: 23 yo man who was involved in a physical altercation. The pt was struck in the back of the head and had his head smashed on a concrete sidewalk. The Pt lost consciousness for an unspecified amount of time. He was taken to a local hospital with a GCS of 9.

Findings: Head CT without contrast (best demonstrates the basilar scull fracture) There are fractures of both temporal bones seen. The right temporal bone demonstrates a 1.5 cm. horizontal fracture that is clearly seen in this section. There is also a longitudinal fracture of the petrous part of the left temporal bone—this one is not as easily seen; however it is best seen in this section. The most posterior fracture line is about 6mm in length. The most anterior fracture line is about 1 cm in length. These two fracture lines can be connected, in which case, it is easily seen that the fracture is interrupted by the mastoid air spaces and that it actually traverses the long axis of the left petrous temporal bone. It is also worth noting the fluid in the mastoid air spaces.

Ddx: Skull fracture Anatomic variant suture

Dxhow: Imaging

Exam: Physical exam at that time was significant for hematotympanum, CSF leakage, Battle's sign, hyperreflexic DTR's, and positive Babinski's. All cranial nerves were intact and there was no evidence of hearing loss. The pt demonstrated marked agitation, disinhibition (use of profanities) disorientation to time and place, urinary incontinence, dysarthria, and ataxia. The pt did well throughout his hospital course and was eventually discharged to a traumatic brain injury program.

No MeSH data available.