The brain is enclosed in a bony shell known as the skull. The skull helps protect the brain from head injuries and head trauma. However, due to high impact in certain cases, the skull bones may break leading to a fracture. Many cases of skull fracture involve cracked bones and no displacement of the broken pieces occurs. Such types of cases are called closed fractures or simple fractures. In case of severe injuries, displacement of skull fracture may occur. The blood vessels in the membranes attached to the brain rupture and cause bleeding. This bleeding occurs in the skull and outer membrane. There are different types of skull fractures of which basilar skull fracture is one. Let us go gain a better understanding of basal skull fractures in the following paragraphs.
What is Basilar Skull Fracture?
Basilar skull fractures are fractures of the base of the skull. This fracture usually involves the temporal bone, occipital bone, sphenoid bone and the ethmoid bone. It causes leakage of the cerebrospinal fluid (CSF) into the ear and nose. The fracture is caused due to a heavy blow on the back of the head or sudden deceleration of the torso. This occurs especially in case of a traffic accident, where a sudden jerk causes separation of the occipital and temporal bones.
When one suffers from a skull fracture, there are various signs that indicate grievous injuries. These symptoms include swelling and bruising on scalp, headache, nausea, vomiting and dizziness. In case of severe skull injury, it may lead to a deformed skull. In some cases, patients lose consciousness, develop seizures and even slip into coma. However, coming to the signs, we find that there are certain typical symptoms that indicate this type of fracture. These signs include raccoon eyes and battle signs behind the ear. These symptoms are discussed in detail in the following paragraphs.
The anterior fossa fracture can lead to raccoon eyes, visual disturbances, altered eye movement, ptosis, loss of sensation, etc. In case of middle fossa fracture, it will lead to loss of lower face sensation, deafness, facial palsym hemotympanum, otorrhea. Posterior fossa fracture causes battle sign behind the ear (ecchymosis) and impaired gag reflex. The other basilar skull fracture signs include bleeding from nose and ears, hemotympanum, cranial nerve palsy and cerebrospinal fluid rhinorrhea. In about 1 to 10% of the patients, ocular nerve entrapment occurs. In case of severe brain injury, it may lead to death.
Diagnosis and Treatment
The basilar skull fracture diagnosis includes CT scan of the brain. It helps identify the fracture in most cases of head injury. The treatment includes careful observation. In case of severe injuries where there is leakage of CSF, surgery is required. There is no other treatment. The fracture tends to heal with time.
In most cases of basilar skull fracture, it tends to heal without much medical intervention. But these patients are more likely to develop meningitis due to leakage of cerebrospinal fluid.
Basilar skull fracture is a very rare type of skull fracture and amounts to about 4% of all head injuries. This type of skull fracture is commonly observed in motor racers and is the common cause of death in car racing accidents. If you have further questions regarding basilar skull fractures, speak to your health care provider for the details.