A common symptom of traumatic brain injury (TBI) is a loss of consciousness, resulting in a risk to the airway.Īs with all trauma, it is essential to understand the mechanism of injury involved in the event when dealing with patients with head injuries also consider the possibility of a cervical spine (neck) injury. The initial care of the head-injured patient is to establish an airway and administer oxygen (if trained). While there is little that can be done for the primary brain injury, protecting the airway and ensuring sufficient breathing and circulation can reduce the effect of secondary damage. secondary brain injury: neurological damage after the initial impact.primary brain injury: direct trauma to the brain and associated vascular injuries sustained as a direct result from the initial collision. ![]() Alcohol may be involved in up to 65 per cent of adult head injuries.īrain injury can be divided into two categories: Falls (22-43%) and assaults (30-50%) are the most common cause of a minor head injury, followed by road traffic collisions (approximately 25%). Although the incidence of head injury is high, the incidence of death from head injury is low (6-10 per 100,000 population per annum).ħ0 – 88% of all people that sustain a head injury are male, 10-19 per cent are aged 65 years or over and 40-50% are children. Death can either be the result of an isolated head injury or due to other traumatic injuries. doi:10.1148/rg.Head injury is the most common cause of death in trauma. CT of Skull Base Fractures: Classification Systems, Complications, and Management. Air in the temporomandibular joint fossa: CT sign of temporal bone fracture. Radiographics : a review publication of the Radiological Society of North America, Inc. ![]() Temporal bone trauma and the role of multidetector CT in the emergency department. Zayas JO, Feliciano YZ, Hadley CR, Gomez AA, Vidal JA. Radiographic classification of temporal bone fractures: clinical predictability using a new system. Temporal bone fractures: traditional classification and clinical relevance. Temporal bone fracture: evaluation and management in the modern era. Delayed-onset or incomplete facial paralysis almost always resolves with conservative management, including the use of tapered-dose corticosteroids. If immediate facial nerve paralysis occurs with loss of electrical response, surgical exploration should be considered. Treatment is based on managing facial nerve injury, hearing loss, vestibular dysfunction, and CSF leakage. In the soft tissues of the infratemporal or temporal fossaeįluid opacification within the temporal bone In the intracranial cavity ( pneumocephalus) In the temporomandibular joint glenoid fossa 8 ![]() Aside from the fracture lucency itself, which may be subtle on thicker slices or some planes, there may be secondary imaging features that, while less specific, raise concern in the setting of trauma for temporal bone fracture 7: Head CT with petrous temporal bone fine slice (≤1 mm) multiplanar bone window reformats is the imaging modality of choice. Sensorineural hearing loss (7-25x as likely)Įpidural hematoma and subarachnoid hemorrhage Other classifications have been proposed as being more clinically relevant, specifically focusing on whether or not the otic capsule is involved, that is otic capsule-violating (OCV) versus otic capsule-sparing (OCS) injuries 4,5,9. Involvement of the otic capsule is a predictor of several serious complications 5,6:Ĭerebrospinal fluid leak (4-8x as likely) Using this plane, fractures may be classified as follows: ![]() Temporal bone fracture is described relative to the long axis of the petrous temporal bone, which runs obliquely from the petrous apex posterolaterally through the mastoid air cells. Fracture of the petrous temporal bone is usually classified according to the main orientation of the fracture plane and/or involvement of the otic capsule.
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