Basilar skull fracture
Basilar skull fracture represents a severe injury with potentially life-threatening complications. Diagnosis relies on clinical signs and imaging methods, with accurate and timely identification being crucial for further therapeutic management. The interactive algorithm will guide users through differential diagnosis, principles of care management for these injuries, and recognition of potential complications in both pre-hospital and hospital care. It highlights the need for interdisciplinary cooperation in the diagnosis and treatment of injuries in this anatomically complex area.
Review
The algorithm is adequately structured, consisting of clearly defined steps that lead to an accurate diagnosis and at the same time provides a concise proposal for causal treatment. This approach contributes to the effective and systematic treatment of craniofacial injuries at various stages of care.
Students will learn about pre-hospital first aid procedures and the principles of stratification of treatment for craniofacial injuries in the context of various medical specialties. They will also understand the importance of interdisciplinary cooperation, which is essential in the diagnosis and treatment of these injuries, and will acquire knowledge about possible intracranial complications related to this issue.
Key aspects of caring for patients with craniofacial injuries include, above all, assessing the state of consciousness and preventing secondary damage to the central nervous system and spinal cord. It is also necessary to correctly indicate surgical intervention based on clinical and radiological findings. Last but not least, it is necessary to take into account the possibility of postoperative complications that may affect the further course of treatment and the overall prognosis of the patient.
Sources
HUELKE, Donald F., SMOCK, William S., FULLER, Peter M., and NICHOLS, George R. Basilar skull fractures produced by facial impacts – case histories and a review of the literature. SAE Technical Paper 881711, 1988. Available from: https://doi.org/10.4271/881711
UMANA, Giovanni E., SCALIA, Giuseppe, FRICIA, Matteo, SCALISE, Silvia, CICERO, Giulio, CHIRICO, Fabio, and GERMANO, Antonino. Cerebrospinal fluid leaks after anterior skull base trauma: a systematic review of the literature. World Neurosurgery, 2022, vol. 159, pp. 19–29. ISSN 1878-8750. Available from: https://doi.org/10.1016/j.wneu.2021.10.065
McCUTCHEON, Brandon A., OROSCO, Ryan K., CHANG, David C., SALAZAR, Francesca R., TALAMINI, Mark A., MATURO, Stephen, and MAGIT, Anthony. Outcomes of isolated basilar skull fracture: readmission, meningitis, and cerebrospinal fluid leak. Otolaryngology–Head and Neck Surgery, 2013, vol. 149, no. 6, pp. 931–939. ISSN 0194-5998. Available from: https://doi.org/10.1177/0194599813508539
DREIZIN, David, MOHINDRA, Ramesh, LIM, Merwyn M., and NAM, Anthony J. CT of skull base fractures: classification systems, complications, and management. RadioGraphics, 2021, vol. 41, no. 7, pp. 1906–1930. ISSN 0271-5333. Available from: https://doi.org/10.1148/rg.2021200189
Learning targets
2) Select the appropriate imaging methods and other diagnostic procedures when suspecting a basilar skull fracture.
3) Learn to recognize and manage potential complications, correctly indicate the patient for further examinations and consultations.
Key points
2) Determination of the correct indication for surgical intervention.
3) Diagnosis and treatment of frontobasal injuries require multidisciplinary collaboration.
Related algorithms
External links
Illustrations generated by the DALL·E neural network (OpenAI) for didactic purposes.
