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Xa1mr0rasi2rrd5lszqu Signature Poli 150208113323 Conversion Gate02 PDF
Xa1mr0rasi2rrd5lszqu Signature Poli 150208113323 Conversion Gate02 PDF
FRACTURES
• indicates that
substantial force has
been applied to the head
and is likely to have
damaged the cranial
contents.
Anatomy Of The Fracture
The brain is surrounded by
1. (CSF)
2. enclosed in meningeal covering
3. and protected inside the SKULL.
The fascia and muscles
of the scalp------------------- additional cushioning
10 times more force is required to fracture a
cadaveric skull with overlaying scalp than the one
without
Anatomy of the fracture
The skull ------
flat bones
cranial sutures.
outer table(1.5mm)
the spongy diploe,
inner table(0.5mm)
a thick, fibrous, dura mater
shallow subdural space
arachnoid mater that covers the
surface of the brain.
• The diploë does not form where the
skull is covered with muscles, leaving
the vault thin and prone to fracture.
THE SITES AT RISK
VAULT BASILAR
LINEAR DEPRESSED
OPEN CLOSED
in a child a long, LINEAR FRACTURE extending from the midline in the occipital
region across the occipital bone into the temporal bone
DEPRESSED FRACTURE
The fractured segments are displaced inward, toward the
meninges and brain for more than 3 mm. (the fragment of
bone is depressed deeper than the adjacent inner table.
A high-energy transfer, such as a blow from a baseball bat
is usually comminuted
Mostly the frontoparietal region,
the bones are thin and
this part of the head is particularly prone to an
assailant's attack.
CLOSED COMPOUND/OPEN
associated with a skin laceration or when the fracture
extends into the paranasal sinuses and the middle-ear
structures
Compound skull fractures occur
when all layers protecting the brain
have been breached from the
meninges to the epidermis
allowing outside environmental
contact with the skull cavity
Sagittal CT images of an
OPEN
, COMMINUTED
,DEPRESSED SKULL
FRACTURE. Associated
Pneumocehalus (small arrows)
SKULL BASE FRACTURES
FRACTURE
SUTURE
1-Greater than 3 mm in width 1-Less than 2 mm in width
2-Widest at the center and narrow at the
ends
2-Same width throughout
3-Runs through both the outer and the 3-Lighter on x-rays compared
inner lamina of bone, hence appears with fracture lines
darker
4-Usually over temporoparietal area
4-At specific anatomic sites
5-Usually runs in a straight line 5-Does not run in a straight
6-Angular turns line
6-Curvaceous
LATERAL SKULL RADIOGRAPH
left-sided fracture. across the occipital and parietal the normal bilateral squamous
bones. temporal sutures, not to be confused with
fractures.
SKULL RADIOGRAPH
ADVANTAGES
• MASS EFFECT,
• BONE INJURIES,
• ACUTE HEMORRHAGE.
CT SCAN
an excellent modality at demonstrating
intermediate and late sequelae of head trauma,
such as
• PORENCEPHALY,
• SUBDURAL HYGROMA
• LEPTOMENINGEAL CYSTS,
• and VASCULAR COMPLICATIONS.
CT SCAN
BLOW-OUT FRACTURE
injury that results from blow to orbit
by object that is too large to enter orbit;
BLOW-IN FRACTURE
occurs when orbital floor fracture
segments herniate upward into orbit, impinging
on inferior orbital muscles or globe
Medial Wall and Orbital Floor Blowout Fractures
Herniation of the orbital fat,
Haemorrage in maxillary sinus
fracture of the bone beneath the right eye with eye
muscle tissue entrapped within the fracture (arrow).
comminuted right orbital roof "blow-in" fracture
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