Basilar Skull Fracture

What is Basilar Skull Fracture

Basilar skull fracture is a break or crack in one of the bones that make up the base of the skull.

This injury often affects the bones around the ears or nose, under the eyes, or near the upper spine. Usually, the fractured bone does not move out of place.

What are the causes?

This injury is caused by a severe, direct hit (blow) to the head, such as from a car crash or a fall from a high place.

What are the signs or symptoms?

Symptoms of this condition may include:

  • Clear liquid leaking from the nose or an ear.
  • Blood leaking from an ear.
  • Sudden loss of hearing or smell.
  • Blurred vision or double vision.
  • Trouble with balance or coordination.
  • Headache.
  • Nausea or vomiting.
  • Weakness or numbness in the face.
  • Bruising around the eyes or behind an ear.
  • Jerky movements you cannot control (seizures).

How is this diagnosed?

This condition may be diagnosed based on:

  • CT scans.
  • “Double ring” or “halo” test. This test looks at blood and fluid that leaks from the ear or nose. If the fluid is red with a clear ring around the edge, this indicates that fluid that surrounds the brain and spinal cord (cerebrospinal fluid) may be leaking.
  • Hearing test.
  • Nerve test. This may be done to check for any damage to your facial nerves.

How is this treated?

In most cases, the fracture can heal without treatment. If you need treatment, it may include:

  • Observation and rest. You may be admitted to a hospital for close observation by a health care team.
  • Medicines. These may be given to relieve symptoms such as headaches, seizures, and nausea.
  • Antibiotic medicines.
  • Surgery. This is done in severe cases, especially if the fracture fragments are affecting brain tissue or if there is nerve damage.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic, take it as told by your health care provider. Do notstop taking the antibiotic even if you start to feel better.

Activity

  • Rest as told by your health care provider. Ask your health care provider when you can return to your normal activities.
  • Do notlift anything that is heavier than 10 lb (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.
  • Do notdrive or use heavy machinery until your health care provider says it is okay.

General instructions

  • Have someone stay with you when you go home. This person will need to observe you closely for next couple of days and make sure that you get medical care if you have problems. Ask your health care provider how long someone should observe you.
  • Do notdrink alcohol until your health care provider says it is okay.
  • Do notblow your nose.
  • Keep your head raised (elevated) when you are lying down.

Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms do not improve.

Get help right away if:

  • You develop new or worse symptoms.
  • You are unusually sleepy (lethargic).
  • You are not acting normally.
  • You have a fever or chills.
  • You have a seizure.
  • You have confusion.
  • You have an increased sensitivity to light.
  • You have increased nausea or vomiting.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • A basilar skull fracture is a break or crack in one of the bones that make up the base of the skull. This injury often affects the bones around the ears or nose, under the eyes, or near the upper spine.
  • This injury is caused by a severe, direct hit (blow) to the head, such as from a car crash or fall from a high place.
  • This condition is generally treated with observation and rest. In some cases, medicines may be prescribed to relieve symptoms. In severe cases, surgery may be needed.
  • When you go home, you must have someone stay with you to observe you closely for next couple of days. Ask your health care provider how long someone should observe you.
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