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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.
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 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.
Decompressive craniectomy (crani-+ -ectomy) is a neurosurgical procedure in which part of the skull is removed to allow a swelling or herniating brain room to expand without being squeezed. It is performed on victims of traumatic brain injury , stroke , Chiari malformation , and other conditions associated with raised intracranial pressure .
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.
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.
Skull x-ray or CT scanning is used if neurological symptoms appear. These measurements are also used if concomitant depressed skull fracture is a possibility. Usual management is mainly observation. Phototherapy may be necessary if blood accumulation is significant leading to jaundice. Rarely, anaemia can develop needing blood transfusion.