A Difficult Noticed Skull Base Fracture

• Published in: Journal of neurological surgery. Part B, Skull base Vol. 75; no. S 02
• Main Authors: Kapucu, Yusuf Burak, Aytekin, A., Gun, R., Parlak, A.
• Format: Conference Proceeding Journal Article
• Language: English
• Published: 17-06-2014
• ISSN: 2193-6331; 2193-634X
• DOI: 10.1055/s-0034-1384168

A 38-year-old man with head trauma was seen in the emergency department. The patient was conscious, well oriented, and cooperative. There was posttraumatic vomiting and neurological examination was normal. A thin fracture line involving the inferolateral part of the right occipital bone, temporal bone, and sphenoid bone, extending vertically to posterior skull base was detected in cranial CT scans. There was no sign of intracranial hemorrhage. The fracture line was extending posteriorly to the occipital condyle and condylar canal was affected. Also, the fracture line was extending to lamboidal suture superiorly and was parallel to the suture. Radiologically it was difficult to distinguish the fracture line with occipital emissary vein and lamboidal suture line and the fracture line was too thin to be noticed at first sight. There was no intracranial hemorrhage in follow-up CT imaging and neurological examination was normal in follow-up. Occipital fracture line extending to skull base may be very thin to be noticed and difficult to distinguish from the natural structures in CT scans.