Emergency Surgery Common Disease Diagnosis and Treatment Routine


Skull fracture

Overview: Simple skull base fracture rare and coexist craniofacial fractures. Skull level of external force, head extrusion deformation, and the head hanging
Straight blow, vertical fall can cause skull fracture. Mainly rely on cerebrospinal fluid ear, nose leak to diagnosis. Skull fracture can be limited to
A cranial fossa, can also be traversed through both sides of the skull base or longitudinal through the anterior, middle posterior fossa, fracture line and often near the nose, rock or milk
Suddenly the same room, and the formation of hidden open fractures, with intracranial secondary infection is the most serious problem.

Clinical manifestations
Anterior cranial fossa fracture
1) bruises around the eyes were purple-blue, commonly known as "Panda eyes."
2) unilateral or bilateral olfactory dysfunction.
3) a few may have optic nerve injury performance.
4) cerebrospinal fluid rhinorrhea
5) showed intracranial gas.
2. Central cranial fossa fracture
(1) Temporal muscle swelling or ear type delayed stasis class.
(2) hearing impaired and facial paralysis, but also the moving eye, the pulley, three and the outclinical nerve source.
(3) Cerebrospinal fluid leak, but also rhinorrhea.
(4) CT showed intracranial gas.

Diagnostic points
1. Clear history of trauma and general nervous system symptoms.
2 cerebrospinal fluid rhinorrhea, ear leaks.
3. skull CT scan may show fracture line.
4 head CT showed intracranial gas.
5. Eyes, temporal, ear, suboccipital swelling congestion.
6. The corresponding brain damage performance.

Treatment programs and principles
Close observation of changes in condition. Watch out for secondary craniocerebral injury.
2. Cerebrospinal fluid leakage should be considered open brain injury, the application of antibiotics to prevent infection.
3. The cerebrospinal can not be self-healing more than 4 weeks should be open to open CSF repair surgery.

I. need to live in specialist wards.
2. Ear and nose can not be stuffed and washed, can be filled with antibiotics in the nostril fluid. Keep ear canal clear ho.
3. Instruct the wounded to not cough, sneeze and snivel.
4. Generally do not do lumbar puncture.
5. Take the lead high, keep the head to the side missed the number of off. Most self-healing in the week.

1. X-ray diagnosis of skull base fracture is small, can capture different angles of the end of the city to increase the detection rate.
2. Secondary frequency of infection should be controlled infection after surgery to repair leaks
3. Prior to determine the missing part of the cerebrospinal fluid, surgery is the key to repair or attack
4. Beware of skull fracture with internal carotid artery sponge match.
5. Delayed cerebrospinal fluid leakage test group with sugars and allergic rhinoceros to make the distinction.
Be wary of delayed cerebrospinal fluid leaks.

Source: AEM Editorial Office