Emergencies >>>> Fracture of the base of the skull - signs and help

Fracture of the base of the skull - signs and help.

A skull base fracture is a type of craniocerebral trauma, accompanied by a fracture of one or a group of bones: occipital, sphenoid, temporal, ethmoid, as well as injury to the neurovascular bundle. In some cases, an injury of this nature is accompanied by the outpouring of cerebrospinal fluid (liquorrhea) into the middle ear, and then into the nasal cavity.

In addition to the outpouring of cerebrospinal fluid and bleeding, a fracture of the skull base can be accompanied by a complication in the form of the formation of a valve mechanism in violation of the ethmoid labyrinth, which creates conditions for air injection into the cranial cavity, which causes compression of the brain.

The cause of the fracture of the base of the skull may be:

sharp braking when driving at high speed,
unsuccessful fall with support on the head or a turn of the neck,
powerful blows to the area of the lower jaw or to the base of the nose with a sharp tilt of the head back.

Signs of a skull base fracture depend on damage to the inner surface of the skull base (three cranial fossae - anterior, middle and posterior).

Fracture of the anterior fossa is accompanied by hemorrhage in the orbital region (in the tissue of the upper and lower eyelids), while bruising in the form of glasses ("glasses symptom") and nosebleeds are formed. This kind of hemorrhage manifests itself two to three days after the injury, which is a distinctive feature of a fracture of the base of the skull, in contrast to a usual blow to the face, when bruises are formed immediately after a blow. With a fracture of the anterior fossa, the trigeminal nerve may be affected, speech and swallowing functions may be impaired, which is accompanied by uncontrolled salivation.

Fracture of the middle fossa is accompanied by injuries in the ear area: outflow of cerebrospinal fluid into the middle ear, rupture of the tympanic membrane, hemorrhages in the area of the mastoid process of the temporal bone, dysfunction of taste buds, hearing loss, hearing loss, impaired functioning of the vestibular apparatus, paralysis of the trigeminal nerve.

Fracture of the posterior cranial fossa is accompanied by trauma to the branches of the trigeminal nerve, hemorrhages in the area of the mastoid process of the temporal bone.

The most dangerous consequence of a skull base fracture is a violation of the connection between the brain and spinal cord, the result of which is complete paralysis of all motor functions.

When providing assistance to a victim with a fracture of the base of the skull, it must be borne in mind that this is a serious condition, which may be accompanied by impaired consciousness, loss of consciousness, bleeding from the mouth, nose, ears, concussion, and accompanying nausea and vomiting, dizziness, headache, disorders breathing. Such a patient needs urgent hospitalization in the neurosurgery department. A fatal outcome of a skull base fracture is possible due to post-traumatic complications (ischemia, hypoxia or cerebral edema, impaired respiratory and cardiac functions). The delivery of the victim to a medical facility must be carried out in an ambulance adapted for seriously ill patients, so as not to aggravate the serious condition and cause additional damage.