Skip to main content

Imaging of Skull Base Fractures and Complications

  • Reference work entry
  • First Online:
Atlas of Emergency Imaging from Head-to-Toe

Abstract

Skull base fractures comprise a small but substantial portion of traumatic injuries with associated potential high morbidity and mortality. However, these injuries can often be difficult to detect both clinically and radiologically. This chapter aims to review the basic anatomy of the skull base, along with important anatomic considerations, mechanisms of injury, key clinical features, distinct fracture patterns, and associated complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 899.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 649.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Anderson PA, Montesano PX. Morphology and treatment of occipital condyle fractures. Spine. 1988; https://doi.org/10.1097/00007632-198807000-00004.

  2. Baugnon KL, Hudgins PA. Skull base fractures and their complications. In: Neuroimaging clinics of North America; 2014. https://doi.org/10.1016/j.nic.2014.03.001.

    Chapter  Google Scholar 

  3. Bernal-Sprekelsen M, Alobid I, Mullol J, Trobat F, Tomás-Barberán M. Closure of cerebrospinal fluid leaks prevents ascending bacterial meningitis. Rhinology. 2005;43(4):277–81. PMID: 16405272.

    Google Scholar 

  4. Bobinski M, Shen PY, Dublin AB. Basic imaging of skull base trauma. J Neurol Surg, Part B: Skull Base. 2016;77(5):381–7. https://doi.org/10.1055/s-0036-1583540.

    Article  Google Scholar 

  5. Connor SEJ, Flis C. The contribution of high-resolution multiplanar reformats of the skull base to the detection of skull-base fractures. Clin Radiol. 2005; https://doi.org/10.1016/j.crad.2005.04.003.

  6. Dahiya R, Keller JD, Litofsky NS, Bankey PE, Bonassar LJ, Megerian CA. Temporal bone fractures: otic capsule sparing versus otic capsule violating clinical and radiographic considerations. J Trauma – Injury Infect Crit Care. 1999; https://doi.org/10.1097/00005373-199912000-00014.

  7. Daudia A, Biswas D, Jones NS. Risk of meningitis with cerebrospinal fluid rhinorrhea. Ann Otol Rhinol Laryngol. 2007;116(12):902–5. https://doi.org/10.1177/000348940711601206.

    Article  PubMed  Google Scholar 

  8. De Foer B, Bali A, Bernaerts A, van Dinther J, Offeciers E, Casselman JW. Temporal bone trauma. In: Skull base imaging. Elsevier Inc.; 2018. https://doi.org/10.1016/b978-0-323-48563-0.00007-6.

    Chapter  Google Scholar 

  9. Feldman JS, Farnoosh S, Kellman RM, Tatum SA. Skull base trauma: clinical considerations in evaluation and diagnosis and review of management techniques and surgical approaches. Semin Plast Surg. 2017;31(4):177–88. https://doi.org/10.1055/s-0037-1607275.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Friedman JA, Ebersold MJ, Quast LM. Post-traumatic cerebrospinal fluid leakage. World J Surg. 2001;25(8):1062–6. https://doi.org/10.1007/s00268-001-0059-7.

    Article  CAS  PubMed  Google Scholar 

  11. Go JL, Acharya J, Branchcomb JC, Rajamohan AG. Traumatic neck and skull base injuries. Radiographics. 2019; https://doi.org/10.1148/rg.2019190177.

  12. Guyer RA, Turner JH. Delayed presentation of traumatic cerebrospinal fluid rhinorrhea: case report and literature review. Allergy Rhinol. 2015;6(3):188–90. https://doi.org/10.2500/ar.2015.6.0132.

    Article  Google Scholar 

  13. Katzen JT, Jarrahy R, Eby JB, Mathiasen RA, Margulies DR, Shahinian HK. Craniofacial and skull base trauma. J Trauma. 2003;54(5):1026–34. https://doi.org/10.1097/01.TA.0000066180.14666.8B.

    Article  PubMed  Google Scholar 

  14. Kennedy TA, Avey GD, Gentry LR. Imaging of temporal bone trauma. Neuroimaging Clin N Am. 2014;24(3):467–86. https://doi.org/10.1016/j.nic.2014.03.003.

    Article  PubMed  Google Scholar 

  15. Kienstra MA, Van Loveren H. Anterior skull base fractures. Facial Plast Surg. 2005;21(3):180–6. https://doi.org/10.1055/s-2005-922857.

    Article  CAS  PubMed  Google Scholar 

  16. Lemole M, Behbahani M. Retrospective study of skull base fracture: a study of incidents, complications, management, and outcome overview from trauma-one-level institute over 5 years. J Neurol Surg Part B: Skull Base. 2013;74:S01. https://doi.org/10.1055/s-0033-1336362.

    Article  Google Scholar 

  17. Leone A, Cerase A, Colosimo C, Lauro L, Puca A, Marano P. Occipital condylar fractures: a review. Radiology. 2000;216(3):635–44. https://doi.org/10.1148/radiology.216.3.r00se23635.

    Article  CAS  PubMed  Google Scholar 

  18. Little SC, Kesser BW. Radiographic classification of temporal bone fractures. Arch Otolaryngol–Head Neck Surg. 2006;132(12):1300. https://doi.org/10.1001/archotol.132.12.1300.

    Article  PubMed  Google Scholar 

  19. Madhusudan G, Sharma RK, Khandelwal N, Tewari MK. Nomenclature of frontobasal trauma: a new clinicoradiographic classification. Plast Reconstr Surg. 2006;117(7):2382–8. https://doi.org/10.1097/01.prs.0000218794.28670.07.

    Article  CAS  PubMed  Google Scholar 

  20. Manson PN, Stanwix MG, Yaremchuk MJ, Nam AJ, Hui-Chou H, Rodriguez ED. Frontobasal fractures: anatomical classification and clinical significance. Plast Reconstr Surg. 2009;124(6):2096–106. https://doi.org/10.1097/PRS.0b013e3181bf8394.

    Article  CAS  PubMed  Google Scholar 

  21. Menkü A, Koç RK, Tucer B, Durak AC, Akdemir H. Clivus fractures: clinical presentations and courses. Neurosurg Rev. 2004;27(3):194–8. https://doi.org/10.1007/s10143-004-0320-2.

    Article  PubMed  Google Scholar 

  22. Pretto Flores L, De Almeida CS, Casulari LA, Andrioli G, De Divitiis E, Foroglou G. Positive predictive values of selected clinical signs associated with skull base fractures. J Neurosurg Sci. 2000;44(2):77–83.

    CAS  PubMed  Google Scholar 

  23. Raut AA, Naphade PS, Chawla A. Imaging of skull base: pictorial essay:[PAUTHORS ], Indian Jo ... Imaging of skull base: Pictorial essay full text imaging of skull base: Pictorial essay:[ PAUTHORS ], Indian Jo ... Important Anatomical Landmarks in Central Skull Base. 2012;1:4–13.

    Google Scholar 

  24. Sakas DE, Beale DJ, Ameen AA, Whitwell HL, Whittaker KW, Krebs AJ, Abbasi KH, Dias PS. Compound anterior cranial base fractures: Classification using computerized tomography scanning as a basis for selection of patients for dural repair. J Neurosurg. 1998;88(3):471–7. https://doi.org/10.3171/jns.1998.88.3.0471.

    Article  CAS  PubMed  Google Scholar 

  25. Slupchynskyj OS, Berkower AS, Byrne DW, Cayten CG. Association of skull base and facial fractures. Laryngoscope. 1992;102(11):1247–50. https://doi.org/10.1288/00005537-199211000-00008. PMID: 1405985.

  26. Stewart RM, Rotondo MF, Nathens AB, Neal M, Caden-Price C, Lynch J, Chang MC, Burd RS, Chung KC, Cuschieri J, Della Rocca GJ, Ellenbogen RG, Fantus RJ, Gibran NS, Hartsock LA, Hemmila MR, Bradford Henley FM, Hunt JP, Mccarthy M, … Weinand M. National trauma data bank report 2016. American College of Surgeons (ACS). 2016. Retrieved 29 Apr 2020 from https://www.facs.org/quality-programs/trauma/tqp/center-programs/ntdb/docpub

  27. Winkler-Schwartz A, Correa JA, Marcoux J. Clival fract bures in a level I trauma center. J Neurosurg. 2015;122(1):227–35. https://doi.org/10.3171/2014.9.JNS14245.

  28. Zayas JO, Feliciano YZ, Hadley CR, Gomez AA, Vidal JA. Temporal bone trauma and the role of multidetector CT in the emergency department. Radiographics. 2011;31(6):1741–55. https://doi.org/10.1148/rg.316115506.

    Article  PubMed  Google Scholar 

  29. Ziu M, Savage JG, Jimenez DF. Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures. Neurosurg Focus. 2012;32(6) https://doi.org/10.3171/2012.4.FOCUS1244.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ngoc-Anh Tran .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Tran, NA., Nunez, D.B., Potter, C.A. (2022). Imaging of Skull Base Fractures and Complications. In: Patlas, M.N., Katz, D.S., Scaglione, M. (eds) Atlas of Emergency Imaging from Head-to-Toe. Springer, Cham. https://doi.org/10.1007/978-3-030-92111-8_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-92111-8_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-92110-1

  • Online ISBN: 978-3-030-92111-8

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics