Clinical significance of skull base fracture in patients after traumatic brain injury

Shlomi Yellinek, Avi Cohen, Vladimir Merkin, Ilan Shelef, Mony Benifla

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

About 4% of all head injuries include skull base fractures. Most of these fractures (90%) are secondary to closed head trauma; the remainder are due to penetrating trauma. We reviewed the records from January 2006 through December 2008 of all patients older than 18 years of age who arrived at Soroka Medical Center in Be'er-Sheva, Israel, with skull base fractures following a traumatic brain injury (TBI). We identified 107 patients with a mean age of 42 years at the time of TBI. Glasgow Coma score on arrival predicted the clinical outcome. We observed temporal fractures in 30% of these patients, occipital fractures in 20%, pyramidal fractures in 19%, anterior skull base fractures in 17%, and multiple fractures in 14%. Cerebrospinal fluid (CSF) leak was observed in 16 patients (15%). Of the patients experiencing CSF leaks, otorrhea occurred in 10 (62%) and rhinorrhea occurred in six (37%). Three patients required surgical intervention to repair the leak. Meningitis occurred in four patients with clinically evident CSF leak. Multiple skull base fractures are associated with poor neurological outcome. The low rate of meningitis in this patient sample implies that there is no indication to administer prophylactic antibiotics to patients with skull base fractures.

Original languageEnglish
Pages (from-to)111-115
Number of pages5
JournalJournal of Clinical Neuroscience
Volume25
DOIs
StatePublished - 1 Mar 2016

Keywords

  • Brain injury
  • CSF leak
  • Skull base fractures

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