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A skull fracture is a break in one or more of the eight bones that form the cranial portion of the skull, usually occurring as a result of blunt force trauma.If the force of the impact is excessive, the bone may fracture at or near the site of the impact and cause damage to the underlying structures within the skull such as the membranes, blood vessels, and brain.
A basilar skull fracture typically requires a significant degree of trauma to occur. [1] It is defined as a fracture of one or more of the temporal, occipital, sphenoid, frontal or ethmoid bone. [1] Basilar skull fractures are divided into anterior fossa, middle fossa and posterior fossa fractures. [1] Facial fractures often also occur. [1]
The Le Fort III fracture (transverse fracture) occurs at the level of the skull base, resulting in complete craniofacial separation of the midface from the base of the skull. [ 2 ] [ 3 ] The fracture line extends through the zygomatic arch , the pterygoid plates , the lateral and medial orbital walls , the nasal bones , and the nasal septum .
Fractures with displacement require surgery consisting of fracture reduction with miniplates, microplates and screws. Gillie's approach is used for depressed zygomatic fractures. [5] The prognosis of tripod fractures is generally good. In some cases there may be persistent post-surgical facial asymmetry, which can require further treatment. [6]
A penetrating head injury, or open head injury, is a head injury in which the dura mater, the outer layer of the meninges, is breached. [1] Penetrating injury can be caused by high-velocity projectiles or objects of lower velocity such as knives, or bone fragments from a skull fracture that are driven into the brain.
Pneumocephalus and comminuted fracture of the frontal sinus Pneumocephalus is the presence of air or gas within the cranial cavity . It is usually associated with disruption of the skull : after head and facial trauma , tumors of the skull base, after neurosurgery or otorhinolaryngology , and rarely, spontaneously.
In case of head injury, a dural tear is likely in case of a depressed skull fracture. A burr hole is made through the normal skull near the fractured portion, and Adson's elevator is introduced. Underlying dura is separated carefully from the overlying depressed bone fragments.
The pterion is the region where the frontal, parietal, temporal, and sphenoid bones join. [1] It is located on the side of the skull, just behind the temple.It is also considered to be the weakest part of the skull, which makes it clinically significant, as if there is a fracture around the pterion it could be accompanied by an epidural hematoma.