Mastoid diagonal transsphenoidal base of skull fracture

Case contributed by A.Prof Frank Gaillard

Presentation

Fall

Patient Data

Age: 35 years
Gender: Male

Left occipital scalp hematoma. Non-displaced left occipital bone skull fracture crosses the transverse sinus and is associated with a venous extradural hematoma. It is unclear if sinus thrombosis is present and a CTV should be obtained.

Fracture extends anteriorly to involve the left condylar canal, hypoglossal canal and jugular foramen. A fracture line is seen to extend through the anterior wall of the left foramen spinosum with no definite fracture of the left carotid canal identified, however, the fracture is seen continuing into the pituitary fossa, sphenoid sinus, right ethmoid air cells and right orbit (without displacement or hematoma). A few tiny bubbles of air mark the trajectory of the fracture.

Small right temporal contusions (contrecoup) with associated right convexity subdural hemorrhage measuring up to 6 mm. Right parafalcine subdural hematoma measures up to 4 mm. Right traumatic parietal subarachnoid blood. No intraventricular blood. No hydrocephalus. 

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Case information

rID: 57545
Published: 4th Jan 2018
Last edited: 14th Aug 2019
Tag: trauma
Inclusion in quiz mode: Included

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