Fractures of the Floor of the Anterior Cranial Fossa

Abstract

We treated 28 patients with anterior cranial fossa floor fractures. Computed tomography (CT) scans adjusted to bone density disclosed three fracture types: (1) penetrating fractures through the orbita or ethmoid sinus; (2) simple or multiple linear fractures; and (3) extensive comminuted anterior cranial fossa floor fractures. Thirteen patients underwent emergent surgery for treatment of open depressed fractures (most common in type 3 fractures), for foreign bodies (in type 1 fractures), and for optic canal decompression. Large dural lacerations were always present in patients with type 3 fractures, and repairs were made with dural substitutes. Only one patient developed postoperative cerebrospinal fluid leakage. Nine (32%) of the patients in our series had visual involvement, but visual acuity recovered or improved in six patients. Our study shows that initial neuroradiologic evaluation with CT scans is important in patients with frontobasal fractures, and that secure dural repair during primary operation helps prevent cerebrospinal fluid leakage.

Osteointegration of a Bisphenol-a-Glycidyl-Dimethacrylate Composite and Its Use in Anterior Skull Base Defects

“…Moreover, these defects may be accompanied with dural tears, which may cause a cerebrospinal fluid leak (CSFL) that possibly leads to life-threatening complications, such as meningitis, pneumocephalus, or intracranial abscess. 1,2 The CSFLs secondary to skull base fractures were reported to occur much more common at the anterior cranial fossa than at the middle and posterior fossae. 3 In addition, besides fractures, removal of bony structures during surgeries for anterior cranial fossa tumors may be a cause for CSFLs.…”

Intracranial Injuries from Dog Bites in Children

“…Regardless of whether the victim was an infant or a toddler, it is our opinion that there should be a low threshold for wound exploration when the injury involves the temporal bone, as it will be more prone to be associated with a dural laceration with or without an extra-axial hemorrhage. We also recommend exploration and debridement for comminuted injuries, because they are more likely to be associated with dural lacerations [19] .…”

9 skull-base traumaSkull-Base Trauma

“…Emergent surgery may be indicated for open or significantly depressed fracture, foreign bodies, or to decompress the optic canal. 13 Dural repair may be needed to avoid or close a post-traumatic CSF leak and to prevent intra cranial infection. CSF leaks sometimes close without direct re pair after ventricular drainage, such as with a lumboperitoneal shunt.…”