Skull base fracture in the child | Skull base fracture

Skull base fracture in the child

Craniocerebral trauma in children and toddlers – caused by e.g. falling from diaper-changing chests, falling down stairs or climbing frames – is unproblematic in most cases. In a few cases, however, serious injuries such as a fracture of the base of the skull can also occur in small children. Diagnosis is not always easy due to the lack of communication skills in small children and different symptoms, which is why close observation of the child after the trauma is essential. Changes in drinking behaviour, reduced chattering, excessive fatigue or slower reactions in small children can already be an indication of impaired consciousness. In general, parents should check if the child reacts normally after a traumatic brain injury, opens his or her eyes, feels a tingling sensation in legs or arms, complains of headaches or nausea or vomiting, clear fluid or blood comes out of the mouth, nose or ears, and the pupils of the eyes are the same size.

Summary

The skull base fracture, which is part of the craniocerebral trauma, describes the injury to the bony structures of the skull base, which is formed by the frontal, wedge, temporal, ethmoid and occipital bone. The classification is based either on the type of fracture (burst fracture, impression fracture) or on its location, whereby frontobasal (front) and laterobasal (lateral) fractures are separated. The clinical picture is characterized by various forms of bleeding, loss of cerebrospinal fluid via the nose or ear (CSF), formation of bruises (eyeglasses, monocular hematoma) and cranial nerve loss.

The most important diagnostic procedure is cranial computed tomography (CT of the head). Alternatively, magnetic resonance imaging (MRI of the head) can be performed. A skull base fracture requires therapy only if a displacement of the fragments (dislocation), liquor leakage or injury to the cranial nerves occurs.

In these cases the fracture is treated surgically. The occurrence of complications in skull base fractures such as ascending infection with meningitis and abscess formation worsen the prognosis.