Cases reported "Skull Fracture, Basilar"

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1/11. Unusual basal skull fracture in a vehicle equipped with an air bag.

    A woman who was the lap/shoulder belt-restrained driver of a car equipped with a full-size air bag was involved in an oblique frontal collision with a tractor-trailer combination. She was extremely out of position, i.e., witnessed to be slumped over the steering wheel before impact. This preimpact positioning led to fatal injuries resulting from the inflating air bag. Postmortem examination showed an unusual partial ring fracture of the base of the skull, which to the authors' knowledge has not previously been reported.
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ranking = 1
keywords = skull fracture, fracture, skull
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2/11. Traumatic basilar artery occlusion caused by a fracture of the clivus--case report.

    A 56-year-old man presented with a rare traumatic basilar artery occlusion caused by a fracture of the clivus. He fell from the height of 2 meters and immediately fell into a coma. head computed tomography (CT) revealed an open depressed fracture, an acute epidural hematoma 1 cm thick in the left middle frontal fossa, and a longitudinal fracture of the clivus. Emergency removal of the hematoma was performed with cranioplasty. head CT 8 hours 50 minutes after injury showed infarctions in the brain stem, cerebellum, and occipital lobes. cerebral angiography revealed occlusion of the basilar artery in the middle part of the clivus. The patient died after 3 days. autopsy revealed that the basilar artery was trapped in the clivus fracture site. Vertebrobasilar artery occlusion due to trapping in a clivus fracture has a very poor prognosis. diagnosis is difficult and generally only confirmed at autopsy. cerebral angiography is recommended in a patient in a deep coma without massive brain contusion at the early stage of head injury to identify the possibility of vertebrobasilar artery occlusion in a clivus fracture.
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ranking = 0.034372544209207
keywords = fracture
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3/11. A rare clival and sellar fracture with pneumatocephalus.

    We present a case of clival and sellar complex fracture produced by an indirect mechanism. This previously healthy patient had an occipital trauma followed by epistaxis. CT showed a clival and sellar fracture with pneumatocephalus. The probable fracture mechanism was contre-coup injury, linked to cerebral shock-wave transmission. This type of fracture is generally observed in the anterior part of the skull base, in a low resistance area. Severe osteoporosis probably accounted for the unusual fracture site in this patient. A mechanism of direct clival transmission is discussed, together with the usual complications of sphenoid injuries.
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ranking = 0.033102044619875
keywords = fracture, skull
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4/11. Growing fractures of the orbital roof. A report of two cases and a review.

    Growing fractures rarely arise in the skull base. Only six cases of orbital roof growing fractures were found in the relevant literature. We report two such cases. The first case was a 2-year-old girl who had progressive proptosis for 6 months following a mild head injury 1 year previously. The second case was a 9-year-old girl with a history of injury at the age of 3 months. She developed eye deviation and proptosis for 1 year. Computed tomography scan is excellent for demonstrating bony defects in the orbital roof, while magnetic resonance imaging is more sensitive in showing the intraorbital extension of a leptomeningeal cyst. Both patients were operated successfully and proptosis disappeared postoperatively. The exact pathophysiology of growing fractures is still debated in the literature, but a dural laceration along a fracture line is noted in all cases, and frontobasal brain injury seems to play an important role in the pathogenesis of the fracture growth. Growing fractures of the orbital roof should be suspected if ocular symptoms appear in a child who had sustained a head injury several months or years before.
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ranking = 0.036539299040796
keywords = fracture, skull
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5/11. Posttraumatic carotid-cavernous sinus fistula.

    BACKGROUND AND OBJECTIVES: Posttraumatic carotid-cavernous sinus fistula is a rare complication of maxillofacial trauma and is seldom discussed in the literature. Motor vehicle accidents, falls, and other crush injuries contribute to the incidence of basilar skull fractures and the formation of fistulae. When injuries occur in the vessel wall, the carotid artery has the potential to fill the low-pressure cavernous sinus. The symptoms include chemosis, proptosis, pulsating exophthalmos, diplopia, ophthalmoplegia, orbital pain, audible bruits, and blindness. methods AND MATERIALS: The conventional treatments include carotid ligation and embolization. These techniques have often proved to be ineffective. A new method--the occlusive balloon technique--has been developed and is described in this article. A clinical case is used to illustrate the procedure. RESULTS AND/OR CONCLUSIONS: Utilization of balloon catheters provides a minimally invasive technique to treat patients, without significant morbidity or mortality. The procedure is found to be successful and predictable.
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ranking = 0.24859899768687
keywords = skull fracture, fracture, skull
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6/11. Longitudinal brainstem laceration associated with complex basilar skull fractures due to a fall: an autopsy case.

    This report describes an autopsy case of a rare longitudinal brainstem laceration associated with complex basilar skull fractures. The victim was a 40-year-old male who died immediately after falling from a roof (9.2m in height) of a factory onto a concrete floor. The postmortem examination revealed an incomplete ring fracture of the base of the skull with longitudinal fractures of the sphenoid (clivus of the dorsum sellae turcicae) and occipital bones, cerebral contusions in the frontal and temporal poles, a longitudinal brainstem laceration at the posterior median sulcus of the pons accompanied with multiple contusional hemorrhages in the brainstem and corpus callosum. Related blunt-force injuries were observed in the parieto-occipital region of the head, shoulder and upper back involving the fractures of the cervical and thoracic vertebrae, and sternum and ribs, indicating a huge impact to the occiput and subsequent impression of the vertebral column into the base of the skull due to violent anteroflexion of the neck, which caused the complex basilar skull fractures, contusions and longitudinal laceration of the brainstem.
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ranking = 1.5062392590472
keywords = skull fracture, fracture, skull
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7/11. meningitis following basal skull fracture in two in-line skaters.

    INTRODUCTION: In-line skating has been reported to cause severe head injury. Basilar skull fracture (BSF) is associated with a high risk of complication. CASE REPORT: We report two children who had bacterial meningitis following seemingly trivial in-line skating injuries. In both, anterior BSF was diagnosed retrospectively following occurrence of streptococcus pneumoniae meningitis. DISCUSSION: The clinical signs indicating BSF depend on the fracture location. Plain skull radiography and computed tomography (CT) are not sensitive enough to detect thin fractures in the anterior cranial fossa. We argue that high resolution multiple-plane CT and coronal T2-weighted magnetic resonance imaging are indicated to diagnose BSF.
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ranking = 1.2520362521078
keywords = skull fracture, fracture, skull
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8/11. Fracture of skull base with delayed multiple cranial nerve palsies.

    This report describes a pediatric case of delayed glossopharyngeal nerve, vagus nerve, and facial nerve palsies after a head injury. Computed tomography scan of the skull base revealed the fracture of the petrous part of the temporal bone, and the fracture involved the tip of petrous pyramid, in front of the jugular foramen. The anatomical features, mechanisms, diagnosis, and treatment are discussed.
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ranking = 0.017708282999783
keywords = fracture, skull
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9/11. Successful treatment of a patient with a 13-year history of post-traumatic rhinorrhea due to malabsorption of cerebrospinal fluid.

    Chronic cerebrospinal fluid (CSF) leaks associated with skull base fractures are rare but intractable and patients may be subjected to numerous operations. We present a 30-year-old man with a 13-year history of chronic CSF rhinorrhea following a cranial trauma. Computed tomography (CT) showed a bone defect in the planum sphenoidale. CT cisternography revealed a leak from the defect and CSF malabsorption. The absence of symptoms of CSF malabsorption may be attributable to external leakage of excess CSF. After closing the leak via the extended transsphenoidal approach we placed a ventriculoperitoneal shunt for occult hydrocephalus. We discuss the clinical symptoms of chronic CSF leakage and present therapeutic strategies dictated by the mechanisms underlying the leak.
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ranking = 0.005604009252509
keywords = fracture, skull
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10/11. carotid-cavernous sinus fistula: a case study.

    Carotid-cavernous sinus fistulae are rare, but serious, vascular anomalies which may develop following traumatic injury to the skull base. Fractures or the shearing forces of severe head trauma may cause the internal carotid artery to be torn from its points of dural attachment and rupture, with resultant direct flow into the cavernous sinus. Current treatment options for carotid-cavernous sinus fistulae are surgery and coil embolization, with embolization being the most common. Clinicians and nurses treating patients with these injuries should have an understanding of this vascular entity, because prompt intervention helps to prevent permanent disability and improve patient outcomes. This case study reports the diagnosis and treatment of a carotid-cavernous sinus fistula that developed several months after a traumatic head injury.
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ranking = 0.0021667548315882
keywords = skull
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