Basilar skull fracture

Basilar skull fracture
Other names	Basal skull fracture, skull base fractures[1]
A subtle temporal bone fracture as seen on a CT scan
Specialty	Emergency medicine, neurosurgery
Symptoms	Bruising behind the ears, bruising around the eyes, blood behind the ear drum[1]
Complications	Cerebrospinal fluid leak, facial fracture, meningitis[2][1]
Types	Anterior, central, posterior[1]
Causes	Trauma[1]
Diagnostic method	CT scan[1]
Treatment	Based on injuries inside the skull[1]
Frequency	≈12% of severe head injuries[1]

A basilar skull fracture is a break of a bone in the base of the skull.^[1] Symptoms may include bruising behind the ears, bruising around the eyes, or blood behind the ear drum.^[1] A cerebrospinal fluid (CSF) leak occurs in about 20% of cases and may result in fluid leaking from the nose or ear.^[1] Meningitis occurs in about 14% of cases.^[2] Other complications include injuries to the cranial nerves or blood vessels.^[1]

A basilar skull fracture typically requires a significant degree of trauma to occur.^[1] It is defined as a fracture of one or more of the temporal, occipital, sphenoid, frontal or ethmoid bone.^[1] Basilar skull fractures are divided into anterior fossa, middle fossa and posterior fossa fractures.^[1] Facial fractures often also occur.^[1] Diagnosis is typically by CT scan.^[1]

Treatment is generally based on the extent and location of the injury to structures inside the head.^[1] Surgery may be performed to seal a CSF leak that does not stop, to relieve pressure on a cranial nerve or repair injury to a blood vessel.^[1] Prophylactic antibiotics do not provide a clinical benefit in preventing meningitis.^[2][3] A basilar skull fracture occurs in about 12% of people with a severe head injury.^[1]