Summary

  • Most common causes include a fall, a traffic accident, or an assault.
  • Skull fractures may be linear or comminuted with multiple fracture lines, may be located on the cranial vault or in the basilar skull, may have a varying degree of depression or elevation, and can also be open or closed. Open fractures communicate with the skin through a wound, a sinus, the ear, or the oropharynx.
  • CT, with thin axial cuts, remains the imaging modality of choice. With basilar skull fractures, 3D reconstructions are useful.
  • May be associated with other significant injuries, most importantly intracranial hemorrhage.
  • For isolated skull fractures, treatment is primarily conservative.
  • Surgical intervention is determined not by the fracture per se but by extent of associated intracranial pathology, cranial nerve deficit, or CSF leak.

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