Consequences of the skull base fracture

forecast

The consequences of a skull base fracture depend on possible complications. The more of them occur, the worse the prognosis is.
There is none Dislocation and the meninges remain intact (no cerebrospinal fluid leakage), heals Skull base fracture usually without permanent damage.

Complications

A fracture of the base of the skull can lead to consequences and complications if not properly treated. These include ascending infections, which include meningitis (meningitis), or the formation of a Brain abscess. Consequences such as inflammation of the skull bones (Osteomyelitis) are conceivable after a skull base fracture, as well as the development of a liquor fistula with connection of the spaces between the meninges to the nose or ear, which in turn poses a risk of germs entering the skull represents. A fistula formation between arterial and venous vessels with resulting Tinnitus (Ringing in the ear) is also possible.

Consequential damage

The consequential damage of a skull base fracture can vary widely. The prognosis can also be different, depending on the consequential damage. Most skull base fractures, however, proceed without any further complications. However, if the meninges are injured and there is a leakage of cerebrospinal fluid (liquor), medical intervention must follow immediately. The leakage of liquor is usually noticeable in that a liquid secretion emerges from the nose (nasal liquorrhea). With the existing opening through the meninges there is a risk of infection, which is why antibiotic therapy should be used. Otherwise, the consequences would be ascending meningitis (meningitis) and a brain abscess, both of which can be fatal in the worst case.

Read more about the topic here Brain abscess.

An infection can also lead to inflammation of the skull bone (osteomyelitis). A liquor fistula, i.e. a passage between the meninges and other structures with a connection to the outside, can also form. This makes it easier for pathogens to enter via the ear and nose.

In addition to consequences caused by infection, there are also consequences caused by swelling or bleeding due to the injury. If, for example, a vessel is injured, intracranial pressure increases as blood escapes into the other tissue. This triggers symptoms such as a severe headache, loss of consciousness, convulsions, or even stopped breathing.
Patients who become unconscious due to a fracture of the base of the skull must therefore be given artificial ventilation immediately, otherwise there is a risk of suffocation.

In the worst case, the treating physicians may have to put a patient into an artificial coma. The artificial coma is a long-term anesthetic that is monitored by intensive care medicine. This is induced when there is an acute danger to life, for example due to an infection with septic shock that has already occurred. The shock is caused by an overreaction of the body or the immune system. The coma allows the body to calm down and the most important functions such as cardiac activity are monitored by intensive care medicine.

Read more on the topic: Cerebral hemorrhage coma

In the case of special fractures that also affect the eye socket, blindness can also occur if the optic nerve (nervus opticus) is pinched or injured. Another consequential damage affecting nervous structures is facial paralysis (paralysis of the Facial nerve). Damage to these nerves leads to paralysis of the facial muscles.

Hearing damage and imbalance are also possible sequelae of a skull base fracture if the fracture line runs through the inner ear. The development of tinnitus (whistling sound) is promoted.

Furthermore, not only can bleeding occur within the skull, but vessels that break through the bone itself can also be injured. For example, if the internal carotid artery is damaged, severe bleeding occurs.

prophylaxis

To the consequences of a Skull base fracture To prevent dangerous situations associated with loss of control should be avoided (for example risky car trips). In addition, appropriate protective measures should be followed, such as wearing a helmet in high-risk sports or wearing a seat belt when driving.