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Brant and Helms -- Neuro


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Where is temporal bone fracture often first suspected?
On head CT to rule out intracranial injury
What are the findings suspicious for temporal bone fracture on head CT?
1) Opacification of mastoid air cells

2) Pneumocephalus

3) Fluid in middle ear

4) Air in the bony labyrinth (rare)
What are temporal bone fractures classified by?
Orientation, with respect to the orientation of the petrous portion of temporal bone
What is the most common type of temporal bone fracture?
That which parallels the long axis of the temporal bone, the longitudinal fracture
What percent?
80% of t-bone fractures
How does it occur?
blow to side of head
Which type of t-bone fx is more severe?
What are common sequelae of longitudinal t-bone fx?
dislocation of ossicles, with resultant conductive hearing loss
How does transverse fracture occur?
Blow to frontal or occipital region
What are common sequelae of longitudinal t-bone fxs?
Sensorineural hearing loss

Severe vertigo

Facial palsy
What percent have facial nerve injury?
What other structure is often injured?
Carotid or jugular
Where do venous epidurals occur?
Along dural venous sinus
Vertex (sup sag sinus)

Posterior fossa (sigmoid sinus)
What are the locations where carotid injury most commonly occurs from trauma?
Points of fixation

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