Fracture of the skull base

Outlined most of the skull base fractures skull covered and the skull base fractures, the majority of the linear fracture. According to anatomic position is : Anterior skull fractures; Fracture of the middle cranial fossa; Fracture of the posterior fossa. Fracture of the skull base usually blunt trauma, fracture itself does not require special handling, mainly intracranial. Skull Base with serious injuries to prevent infection. Generally better prognosis. Pathology Disease (1) calvaria fracture Salam. (2) the role of violence in the vicinity of the skull base plane. (3) the head crush injury, skull widespread violence caused by bending. (4) individual circumstances, the first impact of the vertical direction from the top or falling, buttocks significant. A clinical performance. Anterior skull fracture : forehead swelling of the scalp contusion, eyelid and conjunctiva bleeding grouper, Epistaxis and cerebrospinal fluid rhinorrhea, smell loss or visual impairment, serious cause blindness. 2. Fracture of the middle cranial fossa : temporal contusion and soft tissue swelling, or bleeding ears CSF otorrhea, the facial nerve or the auditory nerve injury, superior orbital fissure syndrome, carotid-cavernous fistula. 3. Fracture of the posterior fossa : occipital or mastoid area Ecchymosis, many hours after the injury appeared. Glossopharyngeal, and vagus hypoglossal nerve dysfunction or medullary injury symptoms. A diagnosis. Clinical signs (1) Anterior skull fracture : subcutaneous and orbital eyeball with membrane bleeding, and performance "Panda" eyes levy. Nasal bleeding and with cerebrospinal fluid rhinorrhea. Can be combined olfactory nerve, the optic nerve and pituitary, hypothalamus and the frontal brain contusion symptoms. (2) fracture of the middle cranial fossa : blood and cerebrospinal fluid canal otorrhea, accompanied acoustic neuromas, facial nerve, the trigeminal nerve, Outreach nerve and temporal lobe brain damage symptoms. A few patients with carotid-cavernous fistula or traumatic aneurysm. (3) fracture of the posterior fossa : mastoid subcutaneous bleeding, swelling, tenderness and sometimes posterior pharyngeal swelling, bleeding or leakage of cerebrospinal fluid. Could be merged glossopharyngeal nerve, the vagus nerve, nerve, hypoglossal nerve and cerebellum, brainstem injury symptoms. 2. Skull Base X-ray showed fractures. Treatment 1. CSF leakage, nose or ear canal partial disinfection, not packing rinse, not to blow nose nose. maintained at the CSF missed posture. Systemic anti-infection treatment. 2. Focused on brain injury, cranial nerve injury and other wounds with treatment. 3. CSF leakage sustained 2-3 weeks or more with the plot intracranial pressure gas caused brain, Craniotomy repair leak. 4. With optic nerve, facial nerve injury, early nerve canal decompression. A drug. Use immediately after injury refined tetanus antitoxin, through the blood-brain barrier easy choice of antibiotics, such as penicillin, Chloramphenicol, the Joint medication to prevent infection, mainly to intravenous drug use. 2. Intracranial infection, should take the inflammatory exudates or CSF culture for bacteria and test to choose effective antibiotics. Ceftazidime serious intracranial infection than ideal results. 3. Merger brain injury, according to the treatment of brain injury. An auxiliary inspection. Simple fractures of the skull base with no brain damage, the ad hoc inspections mainly to the basic checks. 2. Serious injuries, suspected of intracranial hematoma, epilepsy or brain injury should head CT examination, Intracranial a deep understanding of brain magnetic resonance imaging can be more clearly demonstrated the brain stem of the brain. 3. Skull Base X-ray diagnosis rate is not high and does not require conventional photography and projection at the position will add to the seriousness, Neither shooting in the acute phase.