Skull-base trauma: neurosurgical perspective.
Trauma to the cranial base can complicate craniofacial injuries and lead to significant neurological morbidity, related to brain and/or cranial nerve injury. The optimal management involves a multidisciplinary effort. This article provides the neurosurgeon's perspective in management of such trauma using a 5-year retrospective analysis of patients sustaining skull-base trauma. The salient features of anterior and middle skull-base (temporal bone) trauma are summarized, and the importance of frontal basilar trauma as well as brain injury is evident. With these injuries, all cranial nerves (except 9 to 12) are at risk; the olfactory nerve and the facial nerve are the first and second, respectively, to sustain injuries. This retrospective analysis provides a better understanding of cranial base trauma and its management. It emphasizes the multifaceted nature of such trauma and the need to recognize anterior skull-base complications, including cerebrospinal fluid leak and brain injury.
Kruse
J J
JJ
Department of Neurosurgery, Louisiana State University Medical Center, 1542 Tulane Avenue, New Orleans, Louisiana 70112, USA.
Awasthi
D
D
D000328:Adult; D001924:Brain Concussion / Q000601:surgery; D001930:Brain Injuries / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000293:injuries; D020209:Cranial Nerve Injuries / Q000601:surgery; D003399:Craniotomy; D004388:Dura Mater / Q000293:injuries; D020220:Facial Nerve Injuries / Q000601:surgery; D005593:Fracture Fixation, Internal; D005624:Frontal Bone / Q000293:injuries; D005626:Frontal Sinus / Q000293:injuries; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures; D061219:Olfactory Nerve Injuries; D020221:Optic Nerve Injuries / Q000601:surgery; D010348:Patient Care Team; D012189:Retrospective Studies; D019291:Skull Base / Q000293:injuries*; D012887:Skull Fractures / Q000601:surgery*; D013100:Sphenoid Bone / Q000293:injuries; D013353:Subdural Effusion / Q000601:surgery; D013701:Temporal Bone / Q000293:injuries