basilar fracture

頭蓋底骨折

WordNet

1. interrupt, break, or destroy; "fracture the balance of power"
2. breaking of hard tissue such as bone; "it was a nasty fracture"; "the break seems to have been caused by a fall" (同)break
3. fracture a bone of; "I broke my foot while playing hockey" (同)break
4. become fractured; "The tibia fractured from the blow of the iron pipe"
5. break (a bone); "She broke her clavicle"
6. break into pieces; "The pothole fractured a bolt on the axle"
7. violate or abuse; "This writer really fractures the language"
8. the act of cracking something (同)crack, cracking
9. any of several Old World tropical aromatic annual or perennial herbs of the genus Ocimum
10. leaves of the common basil; used fresh or dried (同)sweet_basil
11. of or relating to or located at the base; "the basilar membrane of the cochlea" (同)basilary

PrepTutorEJDIC

1. 〈U〉(特に)骨を折ること;骨を折った状熊 / 〈C〉割れ(裂け)目,(鉱物の)破砕面 / 〈足・腕などを〉‘を'骨折する;…‘を'砕く / 骨折する;砕ける
2. 〈C〉メボウキ(芳香のある草) / 〈U〉バジル(メボウキの葉…香辛料)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/04/08 13:27:52」(JST)

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[Wiki en表示]

Basilar skull fracture
A subtle temporal bone fracture as seen on CT in a person with a severe head injury
Classification and external resources
ICD-10	S02.1
ICD-9	801.1
eMedicine	med/2894

A basilar skull fracture (or basal skull fracture) is a fracture of the base of the skull, typically involving the temporal bone, occipital bone, sphenoid bone, and/or ethmoid bone.

This type of fracture is rare, occurring as the only fracture in just 4% of severe head injury patients.

Such fractures can cause tears in the membranes surrounding the brain, or meninges, with resultant leakage of the cerebrospinal fluid (CSF). The leaking fluid may accumulate in the middle ear space, and dribble out through a perforated eardrum (CSF otorrhea) or into the nasopharynx via the eustachian tube, causing a salty taste. CSF may also drip from the nose (CSF rhinorrhea) in fractures of the anterior skull base, yielding a halo sign. These signs are characteristic for basilar skull fractures.

Signs and symptoms

• Battle's sign - is ecchymosis of the mastoid process of the temporal bone.
• Raccoon eyes - is periorbital ecchymosis i.e. "black eyes"
• Cerebrospinal fluid rhinorrhea
• Cranial nerve palsy
• Bleeding (sometimes profusely) from the nose and ears
• Hemotympanum
• conductive or perceptive deafness, nystagmus, vomitus
• In 1 to 10% of patients, optic nerve entrapment occurs: the optic nerve is pressed by the broken skull bones, causing irregularities in vision.
• Serious cases usually result in death

Pathophysiology

Diagram showing bones that may be involved in a basilar skull fracture

Basilar skull fractures include breaks in the posterior skull base or anterior skull base. The former involve the occipital bone, temporal bone, and portions of the sphenoid bone; the latter, superior portions of the sphenoid and ethmoid bones. The temporal bone fracture is encountered in 75% of all basilar skull fractures and may be longitudinal, transverse or mixed, depending on the course of the fracture line in relation to the longitudinal axis of the pyramid.

Bones may be broken around the foramen magnum, the hole in the base of the skull through which the spinal cord exits and becomes the brain stem, creating the risk that blood vessels and nerves exiting the hole may be damaged.

Due to the proximity of the cranial nerves, injury to those nerves may occur. This can cause palsy of the facial nerve or oculomotor nerve or hearing loss due to damage of cranial nerve VIII.

Management

Evidence does not support the use of prophylactic antibiotics regardless of the presence of a cerebral spinal fluid leak.

Prognosis

Non-displaced fractures usually heal without intervention. Patients with basilar skull fractures are especially likely to get meningitis. Unfortunately, the efficacy of prophylactic antibiotics in these cases is uncertain.

Temporal bone fractures

Acute injury to the internal carotid artery (carotid dissection, occlusion, pseudoaneurysm formation) may be asymptomatic or result in life-threatening hemorrhage. They are almost exclusively observed when the carotid canal is fractured, although only a minority of carotid canal fractures result in vascular injury. Involvement of the petrous segment of the carotid canal is associated with a relatively high incidence of carotid injury.

Society and culture

Basilar skull fractures are a common cause of death in many motor racing accidents. Drivers who have died as a result of basilar skull fracture include Formula One driver Roland Ratzenberger, Indianapolis 500 drivers Bill Vukovich, Tony Bettenhausen, Floyd Roberts, and Scott Brayton, NASCAR drivers Dale Earnhardt Sr., Adam Petty, Tony Roper, Kenny Irwin, Jr., Neil Bonnett, John Nemechek, J. D. McDuffie, and Richie Evans, CART drivers Jovy Marcelo, Greg Moore and Gonzalo Rodriguez, and ARCA drivers Blaise Alexander and Slick Johnson.

To prevent this injury, all major motor sports sanctioning bodies now mandate the use of head and neck restraints, such as the HANS device.

Notes

1. 2001 Daytona 500 and death of Dale Earnhardt

References

External links

• -2093678563 at GPnotebook

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 成人における頭蓋骨骨折 skull fractures in adults
• 2. 小児の頭蓋骨折：臨床的特徴、診断、マネージメント skull fractures in children clinical manifestations diagnosis and management
• 3. 成人における特定病原体により引き起こされる細菌性髄膜炎の治療 treatment of bacterial meningitis caused by specific pathogens in adults
• 4. 小児における耳痛の評価 evaluation of earache in children
• 5. 鈍的脳血管損傷：機序、検査、および診断的評価 blunt cerebrovascular injury mechanisms screening and diagnostic evaluation

English Journal

• Role of Kruppel-like Factor 2 in Intracranial Aneurysm of the Rabbit Model.

• Wu X1, Zhang J2, Huang Q3, Yang P1, Chen J1, Liu J4.
• Cellular and molecular biology (Noisy-le-Grand, France).Cell Mol Biol (Noisy-le-grand).2015 Nov 8;61(7):33-9.
• We investigated expression of Kruppel—like factor 2 (KLF2) and its correlation with basilar artery blood flow rate in the hemodynamically induced aneurysm model built by different methods. New Zealand rabbits were randomly divided into sham—operated group, unilateral ligation of
• PMID 26567602

• The Presence of Clival Foramen Through Multidetector Computed Tomography of the Skull Base.

• Inal M1, Muluk NB, Ozveren MF, Çelebi UO, Şimşek G, Burulday V, Bilgili MY.
• The Journal of craniofacial surgery.J Craniofac Surg.2015 Oct;26(7):e580-2. doi: 10.1097/SCS.0000000000002129.
• OBJECTIVES: Technological advancements in the diagnostic radiology recently permitted reviewing the normal anatomy through multidetector computed tomography (MDCT) imagination. The aim of this paper is retrospectively investigation of the clival foramen and canal through MDCT.MATERIALS AND METHODS:
• PMID 26468827

• Coronoid Fractures.

• Ring D1, Horst TA.
• Journal of orthopaedic trauma.J Orthop Trauma.2015 Oct;29(10):437-40. doi: 10.1097/BOT.0000000000000326.
• Fractures of the coronoid process of the ulna are usually part of a more complex injury. The type of coronoid fracture corresponds with a specific pattern of injury with known pitfalls and recommended treatments. Tip fractures usually correspond with dislocation of the elbow and fracture of the radi
• PMID 25785359

Japanese Journal

• 屈曲転位を伴う軸椎歯突起骨端線離開をきたした2歳児の1手術例 (日本脊椎・脊髄神経手術手技学会 特集号)

• Journal of spine research : official journal of the Japanese Society for Spine Surgery and Related Research 4(7), 1206-1209, 2013-07
• NAID 40019774975

• <b>頭部外傷後の多発脳血管攣縮に対し経皮的血管形成術および局所動注療法を施行して良好な結果を得た一例 </b>

• 日本神経救急学会雑誌 24(3), 91-96, 2012
• NAID 130004623121

• 低速度押しつぶし頭部外傷－low velocity, crushing head injuryの6例－

• 日本救急医学会雑誌 23(9), 415-420, 2012
• NAID 130004542346

Related Links

• basilar fracture - definition of basilar fracture by Medical dictionary

basilar /bas·i·lar/ (bas´ĭ-lar) pertaining to a base or basal part. bas·i·lar (băs′ə-lər) adj. Of, relating to, or located at or near the base, especially the base of the skull. basilar [bas′ilər] Etymology: Gk, basis, foundation pertaining to a ...

• basilar fracture - definition of basilar fracture by The Free ...

bas·i·lar (băs′ə-lər) also bas·i·lar·y (-lĕr′ē) adj. Of, relating to, or located at or near the base, especially the base of the skull: the basilar artery. [New Latin basilāris, from Latin basis, base; see basis.] basilar (ˈbæsɪlə) adj 1. ...

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★リンクテーブル★

リンク元	「頭蓋底骨折」
関連記事	「basilar」「basil」「fracture」

「頭蓋底骨折」

　　[★]

英

basilar skull fracture, basal fracture, basilar fracture, skull base fracture, fracture of the base of skull, fracture of base of skull, basal skull fracture

関

バトル徴候、ブラックアイ

「basilar」

　　[★]

• adj.

• 基部の、脳底の、頭蓋底の

関

base of skull、basicranium、basilaris、cerebral base、cranial base、proximal、proximal region、skull base、stem

　

「basil」

　　[★]

バジル

関

Ocimum basilicum、sweet basil

　 　 　

「fracture」

　　[★]

• n.

• 骨折