Skull Base Fracture in the Middle Cranial Fossa / or Anterior Cranial Fossa / on the Left or Right

A skull base fracture is a skull injury that results from a fracture of the bones that form the base of the cranial part of the skull. The injury is classified as severe because the brain is damaged, and the frontal lobes of the brain and the nerves that arise from the brainstem are affected. The integrity of the dura mater is disrupted, which increases the likelihood of infection entering from outside.

Such an injury may be caused by a road traffic accident, a fall from a significant height, or a blow to the base of the nose or the lower jaw. These injuries are accompanied by significant blood loss and can lead to coma. If help is not provided in time, there is a high rate of fatal outcomes, as well as lifelong disability.

Clinical Signs (by Location):

• fracture of the anterior fossa: nasal bleeding, leakage of cerebrospinal fluid from the ear, bleeding around the eyes ("raccoon eyes" sign), rupture of the eardrum;
• injury to the middle cranial fossa: leakage of blood and cerebrospinal fluid from the ear, partial hearing loss or total deafness, rupture of the eardrum, bruising;
• injury to the posterior cranial fossa: damage to the nerves (optic, auditory, olfactory); the functions of other organs are often impaired, bleeding in the temple area and facial nerve paralysis are observed.

Breathing problems often occur, so it is important to monitor this function while transporting the injured person. All patients need to be taken to a hospital promptly. Their quality of life afterward depends on the quality of first aid and rehabilitation. To detect skull fractures, X-rays are taken in three different projections, and a neurological examination is performed. The diagnosis takes into account the medical history and the features and causes of the injury. Treatment tactics are determined by the severity of the injury.

Sources

• Ukrainian Wikipedia
• World Health Organization
• Journal "Acute and Emergency Conditions in Medical Practice"