A skull fracture is a broken one or more of the eight bones that form part of the skull's skull, usually due to blunt object trauma. If the impact strength is excessive, the bone can be broken at or near the impact site and cause damage to the structures inside the skull such as the membranes, blood vessels, and brain.
While an uncomplicated skull fracture may occur without associated physical or neurological damage and in itself is usually not clinically significant, a healthy bone fracture shows that a large number of forces have been applied and increases the likelihood of associated injury. Any significant blow to the head produces a concussion, with or without loss of consciousness.
The fracture coincides with the above lacerations that tear the epidermis and meninges, or walk through the paranasal sinuses and middle ear structures, bringing the outer environment into contact with the cranial cavity called fracture of the compound. Compound fractures can be either clean or contaminated.
There are four main types of skull fractures: linear, depression, diastasis, and basilar. Linear fractures are the most common, and usually do not require intervention for the fracture itself. Depression fractures are usually diminished, with broken bone fragments shifted in - and may require surgical intervention to repair damaged tissue underneath. Diastatic fractures dilate the cranial sutures and usually affect children under three years of age. Basilar fractures are on the bone at the base of the skull.
Video Skull fracture
Skull
The human skull is anatomically divided into two parts: neurocranium, formed by the eight skull bones that house and protect the brain - and the viscerocranium consisting of fourteen bones, excluding the three ossicles of the inner ear. The term
Eight cranial bones are separated by sutures: one bone, two parietal bones, two temporal bones, one occipital bone, one sphenoid bone, and one ethmoid bone.
The bones of the skull are in three layers: the hard solid layer of the external table ( lamina externa ), diploÃÆ' (red spongy marrow sponge layer in the middle, and the inner compact layer of the inner table < >).
The thickness of the skull varies, depending on the location. Thus the traumatic impact required to cause the fracture depends on the impact site. Thick skulls in glabella, external occipital bulges, mastoid processes, and external angle processes. The skull area that is covered with muscle has no formation basis between the internal and external lamina, which causes the thin bone to be more susceptible to fracture.
Skull fractures occur more easily in temporal and parietal skuamosa bone, sphenoid sinus, magnum foramen (opening at the base of the skull passing through the spinal cord), the temporal ridge of petrous, and the inside of the wing sphenoid at the base of the skull. Middle cranial fossa, depression at the base of the skull cavity forms the thinnest part of the skull and is the weakest part. This area of ​​the cranial floor is further weakened by the presence of some foramen as a result this section is at high risk for basilar skull fractures to occur. Other areas more susceptible to fracture are the cribiform plates, the orbital roof in the anterior cranial fossa, and the area between the mastoid and the dural sinuses in the posterior cranial fossa.
Maps Skull fracture
Type
Linear fracture
The fracture of the linear bone is broken in the bone across the full thickness of the skull from the outside into the table. They are usually quite straight without bone displacement. A common cause of injury is the blunt object trauma in which the impact energy is transferred to a large skull area.
Linear skull fractures usually have little clinical significance unless they are parallel in close proximity or transverse stitches, or they involve a venous sinus groove or vascular tract. The resulting complications may include stitch diastasis, venous sinus thrombosis, and epidural hematoma. In small children, although rare, there is the possibility of developing skull fractures that grow especially if fractures occur in the parietal bone.
Depression fracture
A depressed skull fracture is a type of fracture that is usually caused by blunt object trauma, such as being hit with a hammer, rock or kicked in the head. These types of fractures - which occur in 11% of severe head injuries - are comminuted fractures in which the damaged bone moves inward. A depressed skull fracture poses a high risk of increased pressure on the brain, or bleeding into the brain that destroys delicate tissue.
Compound depression of a skull fracture occurs when there is laceration above the fracture, placing the internal cranial cavity in contact with the external environment, increasing the risk of contamination and infection. In a complex depressive fracture, the dura mater is torn. A depressed skull fracture may require surgery to remove bone from the brain if they suppress it by making a hole in the adjacent normal skull.
Diastatic fractures
A diastatic fracture occurs when a transverse fracture line of one or more cranial stitches causes a widening of the stitches. While this type of fracture is usually seen in infants and young children because the seam has not yet fused can also occur in adults. When a diastasis fracture occurs in an adult it usually affects the lambdoidal suture because the stitches do not fully converge in adults until around age 60.
Diastatic fractures may occur with various types of fractures and are also possible for diastasis from cranial sutures to occur without concurrent fracture. Sutural diastasis may also occur in various congenital disorders such as cleidocranial dysplasia and osteogenesis imperfecta.
Basilar Fracture
The basilar skull fracture is a linear fracture that occurs on the floor of the skull dome (the base of the skull), which requires more power to cause than other areas of neurocranium. Thus they rarely occur, occurring as the only fracture in only 4% of patients with severe head injury.
Basilar fractures have characteristic signs: blood in the sinuses; a clear fluid called cerebrospinal fluid (CSF) leaks from the nose (rhinorrhea) or ear (otorrhea); periorbital ecymosis is often called 'raccoon eyes' (bruises from the orbital of the eye resulting from blood collection there because of leakage from the fracture site); and retroauricular echimosis known as "Battle Signs" (bruises over the mastoid process).
Grow fractures
A growing skull fracture (GSF) is also known as craniocerebral erosion or leptomeningeal cyst because the usual development of cystic mass filled with cerebrospinal fluid is a rare complication of head injury usually associated with skeletal skull fractures of the parietal bone in children below 3 years. It has been reported to older children in skull atipical regions such as bipocytipital and base of the skull and in association with other types of skull fractures. This is characterized by diastatic enlargement of the fracture.
Various factors related to GSF development. The main causative factor is the tears in the dura mater. The skull fracture enlarges because, in part, to rapid brain physiological growth occurs in young children, and cerebrospinal cerebrospinal (CSF) pulsation in the underlying leptomenigeal cystic mass.
Fracture of cranial crack
Skull skull fracture that usually occurs in severe injury in infants less than 1 year is a closed diastatic skull fracture with cerebral extrusion outside the skull outside table under a full scalp.
Acute scalp swelling is associated with this type of fracture. In the vague case of scalp without immediate diagnosis can be done through the use of magnetic resonance imaging thus ensuring faster treatment and avoiding the development of "growing skull fractures".
Fraction compound
The fracture coincides with the above laceration that tears the epidermis and the meninges - or walks through the paranasal sinus and middle ear structure, puts the outer environment in contact with the cranial cavity - is a fracture of the compound.
Compound fractures can be either clean or contaminated. Intracranial air (pneumocephalus) may occur in skull fractures.
The most serious complication of a skull fracture is infection. Increased risk factors for infection include visible contamination, meningeal tears, loose bone fragments and presentation for treatment more than eight hours after initial injury.
Fractures are raised compound
A very high skull fracture is a rare type of skull fracture in which a fractured bone rises above the whole outer skull table. This type of skull fracture is always natural. This can be caused during an attack with a weapon in which the initial blow penetrates the underlying skull and meninges and, during withdrawal, the weapon lifts the cracked part of the skull out. It can also cause the skull to spin when struck in case of blunt trauma, the skull rotates when it attacks an inanimate object such as a fall, or may occur during patient transfer after an initial compound head injury.
Prognosis
Children with simple skull fractures without other concerns are at lower risk for poor outcomes and rarely require aggressive treatment.
The presence of a concussion or skull fracture in people after trauma without intracranial haemorrhage or focal neurologic deficits is indicated in long-term cognitive impairment and emotional lability at nearly double the rate as a patient without any good complications.
Those with skull fractures are shown to have "neuropsychological dysfunction, even in the absence of intracranial pathology or more severe conscious disorders in GCS".
See also
- Le Fort face fracture
- Facial fracture
- Mandibular fracture
References
Bibliography
- Forensic Neuropathology By Jan E. Leestma Publisher: CRC Press; 2 edition (October 14, 2008) Language: English ISBNÃ, 0-8493-9167-9 ISBNÃ, 978-0849391675
- Neuroimaging: Clinical and Physical Principle By Robert A. Zimmerman, Wendell A. Gibby, Raymond F. Carmody Publisher: Springer; First edition (January 15, 2000) Language: English ISBN: 0387949631 ISBNÃ, 978-0-387-94963-5
External links
- Medscape: Imagery in a Skull Fracture
- The growth of skull fractures in Medpix
- "Tutorial: CT in Head Trauma"
- Head Trauma at Emedicine.com
- Skull Fracture in MedPix
- After Philadelphia Children's Injury Hospital
Source of the article : Wikipedia
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