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Basilar Skull Fracture

  • This is a fracture (break or crack) of the basilar bone of the skull, which is part of the floor of the skull that holds the brain.  Fractures in this bone can cause tears in the sack compartments that hold the brain, resulting in a leakage of the cerebral spinal fluid (the fluid that surrounds the brain and spinal cord).

  • Eye Bruising
  • Blood in ear canals
  • Vision abnormalities
  • Facial muscle weakness
  • Hearing Problems
  • Balance problems
  • Sensation problems in face
  • Smelling Difficulties
  • Nasal drip from leaking cerebral spinal fluid

  • Head trauma

  • Laboratory
- Clear dripping fluid in the nose can be checked to see if cerebral spinal fluid is present.
  • Imaging
  1. Skull X-Rays (may be difficult to see)
  2. CT scan of head with focus on bones

  • Treatment is based on the degree of leakage of cerebral spinal fluid.
  • Limited cerebral spinal fluid leak:
  1. Head elevation
  2. Fluid restriction
  3. Acetazolamide (will cause a decrease in total cerebral fluid production, so less fluid pressure to leak)
  4. Lumbar subarachnoid drainage -- drainage of excess fluid if necessary
  5. Antibiotics if signs of infection
  • Persistent cerebral spinal fluid leak
- Surgical repair

  • Seek immediate emergency care.  Proper management usually will need consultation by a neurosurgeon.

  • Acute Subdural Hematoma
  • Intracerebral Hemorrhage
  • Acute Epidural Hemorrhage
  • Head Laceration


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