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Skull Base Trauma
Kristine M. Mosier, DMD, PhD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Traumatic injury of anterior, middle, or posterior skull base

            IMAGING

            • General Features

              • Imaging Recommendations

                • CT Findings

                  • MR Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  Selected References

                                  1. Di Ieva A et al: The comprehensive AOCMF classification: skull base and cranial vault fractures - level 2 and 3 tutorial. Craniomaxillofac Trauma Reconstr. 7(Suppl 1):S103-13, 2014
                                  2. Berne JD et al: A multivariate logistic regression analysis of risk factors for blunt cerebrovascular injury. J Vasc Surg. 51(1):57-64, 2010
                                  3. Maillard AA et al: Trauma to the intracranial internal carotid artery. J Trauma. 68(3):545-7, 2010
                                  4. Ringl H et al: The skull unfolded: a cranial CT visualization algorithm for fast and easy detection of skull fractures. Radiology. 255(2):553-62, 2010
                                  5. Bächli H et al: Skull base and maxillofacial fractures: two centre study with correlation of clinical findings with a comprehensive craniofacial classification system. J Craniomaxillofac Surg. 37(6):305-11, 2009
                                  6. Choi YY et al: Pneumocephalus in the absence of craniofacial skull base fracture. J Trauma. 66(2):E24-7, 2009
                                  7. Dean NR et al: Massive hemorrhage in facial fracture patients: definition, incidence, and management. Plast Reconstr Surg. 123(2):680-90, 2009
                                  8. Kuppermann N et al: Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 374(9696):1160-70, 2009
                                  9. Manson PN et al: Frontobasal fractures: anatomical classification and clinical significance. Plast Reconstr Surg. 124(6):2096-106, 2009
                                  10. Mithani SK et al: Predictable patterns of intracranial and cervical spine injury in craniomaxillofacial trauma: analysis of 4786 patients. Plast Reconstr Surg. 123(4):1293-301, 2009
                                  11. Ringl H et al: Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms. Eur Radiol. 19(10):2416-24, 2009
                                  12. Atabaki SM et al: A clinical decision rule for cranial computed tomography in minor pediatric head trauma. Arch Pediatr Adolesc Med. 162(5):439-45, 2008
                                  13. Anderson DR et al: Jugular venous air after basilar skull fracture. J Trauma. 64(3):847, 2008
                                  14. Hoit DA et al: Angiographic detection of carotid and vertebral arterial injury in the high-energy blunt trauma patient. J Spinal Disord Tech. 21(4):259-66, 2008
                                  15. Nakstad PH et al: Correlation of head trauma and traumatic aneurysms. Interv Neuroradiol. 14(1):33-8, 2008
                                  16. Scholsem M et al: Surgical management of anterior cranial base fractures with cerebrospinal fluid fistulae: a single-institution experience. Neurosurgery. 62(2):463-9; discussion 469-71, 2008
                                  17. Szabo KA et al: Supraorbital approach for repair of open anterior skull base fracture. J Neurosurg Pediatr. 2(6):420-3, 2008
                                  18. Zhao X et al: Basilar skull fracture: a risk factor for transverse/sigmoid venous sinus obstruction. J Neurotrauma. 25(2):104-11, 2008
                                  19. Feiz-Erfan I et al: Incidence and pattern of direct blunt neurovascular injury associated with trauma to the skull base. J Neurosurg. 107(2):364-9, 2007
                                  20. Liang W et al: Traumatic carotid cavernous fistula accompanying basilar skull fracture: a study on the incidence of traumatic carotid cavernous fistula in the patients with basilar skull fracture and the prognostic analysis about traumatic carotid cavernous fistula. J Trauma. 63(5):1014-20; discussion 1020, 2007
                                  21. Wang CH et al: Traumatic pseudoaneurysm of the middle meningeal artery: possible indicators for early diagnosis in the computed tomography era. Surg Neurol. 68(6):676-81; discussion 681-2, 2007
                                  22. Madhusudan G et al: Nomenclature of frontobasal trauma: a new clinicoradiographic classification. Plast Reconstr Surg. 117(7):2382-8, 2006
                                  23. Pretto Flores L et al: Positive predictive values of selected clinical signs associated with skull base fractures. J Neurosurg Sci. 44(2):77-82; discussion 82-3, 2000
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Definitions

                                              • Traumatic injury of anterior, middle, or posterior skull base

                                            IMAGING

                                            • General Features

                                              • Imaging Recommendations

                                                • CT Findings

                                                  • MR Findings

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Staging, Grading, & Classification

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  Selected References

                                                                  1. Di Ieva A et al: The comprehensive AOCMF classification: skull base and cranial vault fractures - level 2 and 3 tutorial. Craniomaxillofac Trauma Reconstr. 7(Suppl 1):S103-13, 2014
                                                                  2. Berne JD et al: A multivariate logistic regression analysis of risk factors for blunt cerebrovascular injury. J Vasc Surg. 51(1):57-64, 2010
                                                                  3. Maillard AA et al: Trauma to the intracranial internal carotid artery. J Trauma. 68(3):545-7, 2010
                                                                  4. Ringl H et al: The skull unfolded: a cranial CT visualization algorithm for fast and easy detection of skull fractures. Radiology. 255(2):553-62, 2010
                                                                  5. Bächli H et al: Skull base and maxillofacial fractures: two centre study with correlation of clinical findings with a comprehensive craniofacial classification system. J Craniomaxillofac Surg. 37(6):305-11, 2009
                                                                  6. Choi YY et al: Pneumocephalus in the absence of craniofacial skull base fracture. J Trauma. 66(2):E24-7, 2009
                                                                  7. Dean NR et al: Massive hemorrhage in facial fracture patients: definition, incidence, and management. Plast Reconstr Surg. 123(2):680-90, 2009
                                                                  8. Kuppermann N et al: Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 374(9696):1160-70, 2009
                                                                  9. Manson PN et al: Frontobasal fractures: anatomical classification and clinical significance. Plast Reconstr Surg. 124(6):2096-106, 2009
                                                                  10. Mithani SK et al: Predictable patterns of intracranial and cervical spine injury in craniomaxillofacial trauma: analysis of 4786 patients. Plast Reconstr Surg. 123(4):1293-301, 2009
                                                                  11. Ringl H et al: Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms. Eur Radiol. 19(10):2416-24, 2009
                                                                  12. Atabaki SM et al: A clinical decision rule for cranial computed tomography in minor pediatric head trauma. Arch Pediatr Adolesc Med. 162(5):439-45, 2008
                                                                  13. Anderson DR et al: Jugular venous air after basilar skull fracture. J Trauma. 64(3):847, 2008
                                                                  14. Hoit DA et al: Angiographic detection of carotid and vertebral arterial injury in the high-energy blunt trauma patient. J Spinal Disord Tech. 21(4):259-66, 2008
                                                                  15. Nakstad PH et al: Correlation of head trauma and traumatic aneurysms. Interv Neuroradiol. 14(1):33-8, 2008
                                                                  16. Scholsem M et al: Surgical management of anterior cranial base fractures with cerebrospinal fluid fistulae: a single-institution experience. Neurosurgery. 62(2):463-9; discussion 469-71, 2008
                                                                  17. Szabo KA et al: Supraorbital approach for repair of open anterior skull base fracture. J Neurosurg Pediatr. 2(6):420-3, 2008
                                                                  18. Zhao X et al: Basilar skull fracture: a risk factor for transverse/sigmoid venous sinus obstruction. J Neurotrauma. 25(2):104-11, 2008
                                                                  19. Feiz-Erfan I et al: Incidence and pattern of direct blunt neurovascular injury associated with trauma to the skull base. J Neurosurg. 107(2):364-9, 2007
                                                                  20. Liang W et al: Traumatic carotid cavernous fistula accompanying basilar skull fracture: a study on the incidence of traumatic carotid cavernous fistula in the patients with basilar skull fracture and the prognostic analysis about traumatic carotid cavernous fistula. J Trauma. 63(5):1014-20; discussion 1020, 2007
                                                                  21. Wang CH et al: Traumatic pseudoaneurysm of the middle meningeal artery: possible indicators for early diagnosis in the computed tomography era. Surg Neurol. 68(6):676-81; discussion 681-2, 2007
                                                                  22. Madhusudan G et al: Nomenclature of frontobasal trauma: a new clinicoradiographic classification. Plast Reconstr Surg. 117(7):2382-8, 2006
                                                                  23. Pretto Flores L et al: Positive predictive values of selected clinical signs associated with skull base fractures. J Neurosurg Sci. 44(2):77-82; discussion 82-3, 2000