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| | ==Background== |
| | | *fxs are predictors of intracranial inj |
| SKULL FRACTURES
| | *infants higher risk for fx since thinner bones |
| | | *most fxs have hematomas |
| - fxs are predictors of intracranial inj
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| - fx can lead to complications
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| - infants higher risk for fx since
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| o thinner bones- fx parietal first, then occ, frontal, temp
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| o linear fx most common- then depressed and basilar
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| - most fxs have hematomas
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| - larger hematoma more likely to have fx
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| - basilar skull fx usually have hemotympanum, battle sign, csf leak, CN palsy
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| - 30% of linear skull fx have intracranial inj but 40- 100% of intracranial inj assoc with fx
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| - linear fx heal without complication except growing skull fx
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| - growing skull fx- enlarge overtime producing cranial defect- from tear in dura. CSF pulsation or meninges herniation and bone remodeling. Usually >3mm separation and present 18 mo after initial injury. Most need surg
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| - depressed skull fx- complications include intracranial hem, dural laceration, sz, focal neuro,
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| - basilar skull fx- bleed into middle ear, mastoid air cells, csf leak and meningitis,, hearing loss, CN 6-7-8 defect- transient or permanent
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| - no prophylactic abx- leaks usually stop in 1 wk
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| - plain xrays better than ct to dx skull fx but still need ct to eval brain
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| [[Category:Peds]] | | [[Category:Peds]] |
| | [[Category:Neuro]] |
