Fracture of base of skull. Clinical picture

Fractures of segments of the skull are divided into basal and convective. In severe injuries, cracks in the vault area may form. They can spread to the ground.

There is a definite classification of the lesion depending on the nature. So, distinguish cracks, perforated (fractures with defects), comminuted fractures.

CCT may be accompanied by a divergence of sutures.This defeat is not essentially a fracture. Cracks in the arch do not require, as a rule, special treatment. For several weeks, the cracks are filled first with connective tissue, and then with bone tissue.

Indications for surgery with splinter lesions occur when there is deformation with the displacement of fragments into the cavity (depressed fracture of the skull).

In the case when under the influence of intracranialpressure the brain begins to prolapse (fall and protrude) into the wound, it is impossible to sew a hard shell. In such situations, it is more appropriate to carry out the sheathing of the shell. For this, a wide fascia of the thigh, a periosteal aponeurotic flap or artificial substitutes is used. Bone fragments are removed. In order to prevent liquorrhea layer-by-layer sew soft tissue.

Fracture of the base of the skull, as a rule,accompanied by bruises of the basal brain, stem departments. There are also signs of nerve damage. Fracture of the base of the skull has the appearance of a crack, often passing through the paranasal sinuses, the pyramid of the temporal bone segment, the Turkish saddle. With simultaneous damage to the mucosa of the paranasal sinuses and the membrane, there is a high probability of infection of the brain. This is due to the emerging communication between the airborne ancillary sites and the cerebrospinal fluid spaces. These lesions are characterized as penetrating.

Fracture of the base of the skull is manifestedcerebral symptoms. The condition also includes manifestations of stem disorders, nerve damage, liquorrhea and bleeding from the ears, mouth, nose, and nasopharynx. Bleeding from the auditory canal is observed when the pyramid of the temporal osseous segment is damaged in combination with damage to the tympanic membrane; from a nose - at a lesion of a trellised bone; from the nasopharynx and mouth - if the wedge element is damaged.

Liquorrhea with cerebrospinal fluidtestifies that, in addition to the fact that a fracture of the base of the skull takes place, the cerebral membrane is damaged. In this case, bleeding from the ears and nose becomes a diagnostic sign in the event that occurs in conjunction with neurological manifestations. Minor bleeding intensity stops quite easily. They, as a rule, do not indicate a fracture. Abundant and prolonged bleeding, on the contrary, usually indicates the presence of serious injury.

Fracture of base of skull. Effects

Presence of gross injuries of the basal partsimmediately after the injury or for a short time can lead to death. Some patients may be in a serious condition for a fairly long period. In this case, fracture of the base of the skull is accompanied by anxiety, anxiety, upset of the respiratory apparatus and heart. The most dangerous complication is purulent meningitis.