Skip to main content

Neurocranial Injuries in Craniofacial/Skullbase Fractures

  • Chapter
Craniofacial Trauma

Abstract

Depending on the size and extent of the osseous injuries to the craniofacial area, there are associated intracranial injuries in about 20–30% of the cases (Manson et al. 1987; Neidhardt 2002). In the present series, 56% of all patients were found to have at least a dural tear, whereas in only 17% a dural injury was suspected before surgery. On imaging studies, additional cerebral contusions were seen in 42%, brain oedema in 11% and intracranial hemorrhages in 25%.

Contributed by Karl Kothbauer, Kantonsspital Luzern (CH), Neurosurgical Department, Luzern, Switzer­land

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Buchanan RJ, Brant A, Marshall LF (2004). Traumatic cerebrospinal fluid fistulas. In: HR Winn (ed), Youmans neurological surgery (4th edn). Saunders: Philadelphia, pp 5265–5272.

    Google Scholar 

  • Bullock MR, Chesnut R, Ghajar J et al. (2006a). Surgical management of acute epidural hematomas. Neurosurgery 58, 3 Suppl: S7–S15.

    PubMed  Google Scholar 

  • Bullock MR, Chesnut R, Ghajar J et al. (2006b). Surgical management of acute subdural hematomas. Neurosurgery 58, 3 Suppl: S16–S24.

    PubMed  Google Scholar 

  • Bullock MR, Chesnut R, Ghajar J et al. (2006c). Surgical management of depressed skull fractures. Neurosurgery 58, 3 Suppl: S56–S60.

    PubMed  Google Scholar 

  • Bullock MR, Chesnut R, Ghajar J et al. (2006d). Surgical management of traumatic parenchymal lesions. Neurosurgery 58, 3 Suppl: S25–S46.

    PubMed  Google Scholar 

  • Bullock R, Chesnut RM, Clifton G et al. (1996). Guidelines for the management of severe head injury. Brain Trauma Foundation. Eur J Emerg Med 3:109–127.

    Article  PubMed  CAS  Google Scholar 

  • Dagi TF, George EG (1988). The management of cerebrospinal fluid leaks. In: HH Schmidek, WH Sweet (eds), Operative neurosurgical techniques (vol I) (2 edn). Saunders: Philadelphia, pp 57–69.

    Google Scholar 

  • Flanagan JC, McLachlan DL, Shannon GM (1980). Orbital roof fractures. Neurologic and neurosurgical considerations. Ophthal­mology 87: 325.

    CAS  Google Scholar 

  • Fonseca RJ (2000). Cerebrospinal fluid rhinorrhea and otorrhea. In: RJ Fonseca (ed), Oral and maxillofacial surgery (vol 3). Saunders: Philadelphia, pp 187–188.

    Google Scholar 

  • Fonseca RJ, Walker RV (1991). Oral and maxillofacial trauma (vol 1). Saunders: Philadelphia.

    Google Scholar 

  • Georgiade N, Georgiade G, Riefkohl R, Barwick W (eds) (1987). Essentials of plastic maxillofacial and reconstructive surgery. Williams and Wilkins: Baltimore.

    Google Scholar 

  • Godbersen GS, Kügelgen C (1998a). Klassifikation von Stirn­höhlenwandfrakturen. In: R Schmelzle (ed), Schädelbasis­chirurgie. Al-Budoor: Damaskus, pp 22–27.

    Google Scholar 

  • Godbersen GS, Kügelgen C (1998b). Operative Versorgung von Duraverletzungen nach Stirnhöhlenwandfraktur. In: R Schmelzle (ed), Schädelbasischirurgie. Al-Budoor: Damaskus, pp 187–191.

    Google Scholar 

  • Gruss JS, Ellenbogen RG, Whelan MF (2004). Craniofacial trauma. In: HR Winn (ed), Youmans neurological surgery (4th edn). Saunders: Philadelphia, pp 5243–5264.

    Google Scholar 

  • Hubbard JL, Thomas JM, Pearson PW et al (1985). Spontaneous cerebrospinal fluid rhinorrhoea. Evolving concepts in diagnosis and surgical management. Neurosurgery 16: 312.

    Google Scholar 

  • Jamieson KG, Yelland JD (1973). Surgical repair of the anterior fossa because of rhinorrhoea aerocele or meningitis. J Neurosurg 39: 328.

    Article  PubMed  CAS  Google Scholar 

  • Joss U, Piffko J, Meyer U (2001). Behandlung von frontobasa­len Traumen und Polytraumen. Mund Kiefer GesichtsChir 5: 86–93.

    Article  Google Scholar 

  • Kaestner S, Schroth I, Deinsberger W, Joedicke A, Boeker DK (1998). Verzögernd auftretende Liquorfisteln. In: R Schmelzle (ed), Schädelbasischirurgie. Al-Budoor: Damaskus, pp 199–201.

    Google Scholar 

  • Lewin W (1966). The managment of head injuries. Bailliére, Tindall und Cassell: London.

    Google Scholar 

  • Lewin W (1974). Cerebrospinal fluid rhinorrhoe in nonmissile head injuries. Clin Neurosurg 12: 237.

    Google Scholar 

  • Loew F, Pertuiset B, Chaumier EE, Jaksche H (1984). Traumatic, spontaneous and postoperative CSF rhinorrhea. Adv Tech Stand Neurosurg 11: 169–207.

    Article  PubMed  CAS  Google Scholar 

  • Manson P, French J, Hoopes J (1987). Managment of midfacial fractures. In: N Georgiade, G Georgiade, R Riefkohl, W Barwick (eds), Essentials of plastic maxillofacial and reconstructive surgery. Williams and Wilkins: Baltimore.

    Google Scholar 

  • Markwalder T (1981). Chronic subdural hematomas: A review. J Neurosurg 54: 637–645.

    Article  PubMed  CAS  Google Scholar 

  • Markwalder TM, Seiler RW (1985). Chronic subdural hematomas: to drain or not to drain. Neurosurgery 16: 185–188.

    Article  PubMed  CAS  Google Scholar 

  • McGee EE, Cauthen JC, Bracken CE (1970). Meningitis following acut traumatic cerebrospinal fistula. J Neurosurgery 33: 312–316.

    Article  Google Scholar 

  • Neidhardt O (2002). Kraniofaziale und frontobasale Schädelv­erletzungen Retrospektive Nachuntersuchung, MKG-Klinik-Kantonspital Luzern Dissertation, Universität Basel.

    Google Scholar 

  • O Brian MD, Reade PC (1984). The management of dural tear resulting from midfacial fracture. Head Neck Surg 6: 810.

    Article  Google Scholar 

  • Ommaya AK (1985). Cerebrospinal fluid fistula. In: RH Wilkins, SS Rengachary (eds), Neurosurgery (2 vol). McGraw-Hill: New York, pp 1637–1647.

    Google Scholar 

  • Paillas JE, Pellet W, Demard F (1967). Osteomeningeal fistulas of the base of the skull with leakage of cerebrospinal fluid. J Chir (Paris) 94, 4: 295–316.

    Google Scholar 

  • Probst C (1971). Frontobasale Verletzungen. Huber: Bern.

    Google Scholar 

  • Probst C (1986). Neurosurgical aspects of frontobasal injuries with cerebrospinal fluid fistulas: experience with 205 operated patients. Akt Traumatol 16, 2: 43–49.

    Google Scholar 

  • Probst C, Tomaschett C (1990). The neurosurgical treatment of traumatic fronto-basal spinal fluid fistulas (1982–1986). Akt Traumatol 20, 5: 217–225.

    Google Scholar 

  • Rengachary SS, Ellenbogen RG (2004). Principles of neurosurgery (2nd edn). Elsevier: Mosby, pp 301–368.

    Google Scholar 

  • Russell T, Cummins BH (1984). Cerebrospinal fluid rhinorrhea 34 years after trauma: a case report and review of the literature. Neurosurgery 15, 5: 705–706.

    Article  Google Scholar 

  • Sakas DE, Beale DJ, Ameen AA, Whitwell HL, Whittaker KW, Krebs AJ, et al (1998). Compound anterior cranial base fractures: classification using computerized tomography scanning as a basis for selection of patients for dural repair. J Neurosurg 88, 3: 471–477.

    Article  Google Scholar 

  • Schaller B (2002). Das Schädelhirntrauma - Neue pathophysiologische und therapeutische Gesichtspunkte. Swiss Surg 8: 123–137.

    Article  PubMed  Google Scholar 

  • Schick B, Weber R, Mosler P, Keerl R, Draf W (1997). Long-term follow-up of fronto-basal dura-plasty. HNO 45, 3: 117–122.

    Article  Google Scholar 

  • Schmidek HH, Sweet WH (1988). Operative neurosurgical techniques (vol I). Saunders: Philadelphia.

    Google Scholar 

  • Spetzler RF, Zabramski JM (1986). Cerebrospinal fluid fistula. Contemp Neurosurg 8: 1–7.

    Google Scholar 

  • Sprick C (1988). Komplikationen bei und nach neurochirurgischen Eingriffen beim Schädel-Hirn-Trauma. In: W Bock, J Schirmer (eds), Komplikationen bei neurochirurgischen Eingriffen Zuckschwerdt. München: Bern.

    Google Scholar 

  • Stiell IG, Wells GA, Vandemheen K et al (2001). The Canadian head CT rule for patients with minor head injury. Lancet 357: 1391–1396.

    Article  PubMed  CAS  Google Scholar 

  • Teasdale G, Jennett B (1974). Assessment of coma and impaired consciousness. A practical scale. Lancet 2: 81–84.

    Article  CAS  Google Scholar 

  • Watson B (1967). Treatment of basal skull fractures with and without cerebrospinal fluid fistulae. J Neurosurg 26: 57–61.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hardt, N., Kuttenberger, J. (2010). Neurocranial Injuries in Craniofacial/Skullbase Fractures. In: Hardt, N., Kuttenberger, J. (eds) Craniofacial Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33041-7_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-33041-7_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33040-0

  • Online ISBN: 978-3-540-33041-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics