Skull Fractures Flashcards
how do skull fractures occur?
when forces striking the head exceed the mechanical integrity of the skull
Skull Fractures
which bone is most likely to fracture? next 3 most likely?
- parietal
- temporal, occipital, frontal
Skull Fractures
most common fracture type? next 2 most likely?
- linear
- depressed, basilar
Skull Fractures
most common causes of head injuries
- falls
- assaults
- MVCs
- penetrating missiles
Skull Fractures
bones of the skull
- frontal
- ethmoid
- sphenoid
- occiptal
- 2 parietal
- 2 temporal
Skull Fractures
avg thickness of bones in adults
2-6mm
temporal region is the thinnest
Skull Fractures
immbolize what with any skull fracture associated w/ head injury?
c-spine and t-spine
Skull Fractures
what to do when pt arrives to ER w/ skull fracture
3
- identify & stabilize life threatening injuries
- protect and stabilize airway
- then assess for: altered mental status, focal neurologic deficits, scalp lacerations, bony step off, periorbital or retroauricular ecchymosis
Skull Fractures
what should you not do to scalp wounds?
probe them
Skull Fractures
dx
- non-contrasted CT
- MRI if suspecting vascular or ligament injury
- NO BENEFIT of skull x rays
Skull Fractures
dx if basilar fracture is suspected
- CT angiography to assess for vascular injury
Linear Skull Fractures
describe this fracture type
single fracture that extends through the entire thickness of the skull
Linear Skull Fractures
most often involve which bones?
- temporoparietal
- frontal
- occipital
Linear Skull Fractures
clinical significance
minimal!
Linear Skull Fractures
when is there clinical significance?
- if the linear fracture crosses the middle meningeal groove in the temporal bone or major venous sinuses
Linear Skull Fractures
why is it worrying if the linear fracture crosses the middle meningeal groove or major venous dural sinuses?
- can cause significant extra axial bleeding (beneath the skull but outside the brain parenchyma)
Linear Skull Fractures
common presentation
- if simple + closed: no neurologic sx
- can have swelling over fracture site