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
Dreizin D et al: CT of skull base fractures: classification systems, complications, and management. Radiographics. 200189, 2021
Quirk B et al: Skull base imaging, anatomy, pathology and protocols. Pract Neurol. 20(1):39-49, 2020
Varshneya K et al: Risks, costs, and outcomes of cerebrospinal fluid leaks after pediatric skull fractures: a MarketScan analysis between 2007 and 2015. Neurosurg Focus. 47(5):E10, 2019
Bobinski M et al: Basic imaging of skull base trauma. J Neurol Surg B Skull Base. 77(5):381-7, 2016
Gordts F et al: Basilar skull fractures: the petrous bone. B-ENT. Suppl 26(1):193-201, 2016
Baugnon KL et al: Skull base fractures and their complications. Neuroimaging Clin N Am. 24(3):439-65, vii-viii, 2014
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
Gray ST et al: Pathophysiology of iatrogenic and traumatic skull base injury. Adv Otorhinolaryngol. 74:12-23, 2013
Lin DT et al: Surgical treatment of traumatic injuries of the cranial base. Otolaryngol Clin North Am. 46(5):749-57, 2013
Berne JD et al: A multivariate logistic regression analysis of risk factors for blunt cerebrovascular injury. J Vasc Surg. 51(1):57-64, 2010
Maillard AA et al: Trauma to the intracranial internal carotid artery. J Trauma. 68(3):545-7, 2010
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
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
Choi YY et al: Pneumocephalus in the absence of craniofacial skull base fracture. J Trauma. 66(2):E24-7, 2009
Dean NR et al: Massive hemorrhage in facial fracture patients: definition, incidence, and management. Plast Reconstr Surg. 123(2):680-90, 2009
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
Manson PN et al: Frontobasal fractures: anatomical classification and clinical significance. Plast Reconstr Surg. 124(6):2096-106, 2009
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
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
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
Anderson DR et al: Jugular venous air after basilar skull fracture. J Trauma. 64(3):847, 2008
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
Nakstad PH et al: Correlation of head trauma and traumatic aneurysms. Interv Neuroradiol. 14(1):33-8, 2008
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
Szabo KA et al: Supraorbital approach for repair of open anterior skull base fracture. J Neurosurg Pediatr. 2(6):420-3, 2008
Zhao X et al: Basilar skull fracture: a risk factor for transverse/sigmoid venous sinus obstruction. J Neurotrauma. 25(2):104-11, 2008
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
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
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
Madhusudan G et al: Nomenclature of frontobasal trauma: a new clinicoradiographic classification. Plast Reconstr Surg. 117(7):2382-8, 2006
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
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References
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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
Dreizin D et al: CT of skull base fractures: classification systems, complications, and management. Radiographics. 200189, 2021
Quirk B et al: Skull base imaging, anatomy, pathology and protocols. Pract Neurol. 20(1):39-49, 2020
Varshneya K et al: Risks, costs, and outcomes of cerebrospinal fluid leaks after pediatric skull fractures: a MarketScan analysis between 2007 and 2015. Neurosurg Focus. 47(5):E10, 2019
Bobinski M et al: Basic imaging of skull base trauma. J Neurol Surg B Skull Base. 77(5):381-7, 2016
Gordts F et al: Basilar skull fractures: the petrous bone. B-ENT. Suppl 26(1):193-201, 2016
Baugnon KL et al: Skull base fractures and their complications. Neuroimaging Clin N Am. 24(3):439-65, vii-viii, 2014
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
Gray ST et al: Pathophysiology of iatrogenic and traumatic skull base injury. Adv Otorhinolaryngol. 74:12-23, 2013
Lin DT et al: Surgical treatment of traumatic injuries of the cranial base. Otolaryngol Clin North Am. 46(5):749-57, 2013
Berne JD et al: A multivariate logistic regression analysis of risk factors for blunt cerebrovascular injury. J Vasc Surg. 51(1):57-64, 2010
Maillard AA et al: Trauma to the intracranial internal carotid artery. J Trauma. 68(3):545-7, 2010
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
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
Choi YY et al: Pneumocephalus in the absence of craniofacial skull base fracture. J Trauma. 66(2):E24-7, 2009
Dean NR et al: Massive hemorrhage in facial fracture patients: definition, incidence, and management. Plast Reconstr Surg. 123(2):680-90, 2009
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
Manson PN et al: Frontobasal fractures: anatomical classification and clinical significance. Plast Reconstr Surg. 124(6):2096-106, 2009
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
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
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
Anderson DR et al: Jugular venous air after basilar skull fracture. J Trauma. 64(3):847, 2008
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
Nakstad PH et al: Correlation of head trauma and traumatic aneurysms. Interv Neuroradiol. 14(1):33-8, 2008
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
Szabo KA et al: Supraorbital approach for repair of open anterior skull base fracture. J Neurosurg Pediatr. 2(6):420-3, 2008
Zhao X et al: Basilar skull fracture: a risk factor for transverse/sigmoid venous sinus obstruction. J Neurotrauma. 25(2):104-11, 2008
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
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
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
Madhusudan G et al: Nomenclature of frontobasal trauma: a new clinicoradiographic classification. Plast Reconstr Surg. 117(7):2382-8, 2006
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
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