Annual Report

Executive Editor: Daniel Buchbinder General Editor: Daniel Buchbinder

Authors: S Fusetti, B Hammer, R Kellman, C Matula, EB Strong, Co-author: A Di Ieva

Skull base & Cranial vault - Skull base, anterior

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Glossary

General considerations

Fractures of the anterior skull base are difficult to diagnose especially when they are not associated with CSF leak, bleeding or CNS injury. High resolutions CT scans can help make the diagnosis of anterior skull base fractures.

Observation
Main indication Skill Equipment
Non- or minimally displaced fractures without CNS injury. Basic surgical experience, no specialized skills Basic equipment only

Further indication

  • Stable neurological status (high Glasgow coma scale GSC)
Intradural repair
Main indication Skill Equipment
Displaced fractures with evidence of CNS injuries. Highly experienced and skilled surgeon Simple surgical and imaging resources

Further indications

Evidence of:

  • Pneumocephalus
  • Increased intracranial pressure
  • Other neurological symptoms
  • Bony fragments displaced into the parenchyma of the brain
  • Dural injury
Extradural repair
Main indication Skill Equipment
Displaced fractures with evidence of CNS injuries or CSF leak that does not resolve spontaneously. Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Further indications

Evidence of:

  • Pneumocephalus
  • Increased intracranial pressure
  • Other neurological symptoms
  • Bony fragments displaced into the parenchyma of the brain.
  • Dural injury
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2011-05-14