Fractures of the Skull Base (Cerebral Concussion)

Figure comm_13a_n.jpg to comm_13e_n.jpg: Distant hematomas, bleedings of the orifices, and oto- and rhinoliquorrhea indicate fractures of the base of the skull. Figure comm_13a_n.jpg and figure comm_13b_n.jpg: A bilateral orbita hematoma may be observed in basal skull fracture; however, it is no proof of a basal skull fracture because it may also occur after a contusion of one orbita with secondary expansion to the other side, or due to a galea hematoma. In the 7.7-year-old boy, the bilateral orbita hematoma is due to a basal skull fracture. And in the following teenager, it is a sequel of bleeding into the galea following a shunt revision. Figure comm_13c_n.jpg: Retromastoidal hematomas are frequently not recognized and may be very discrete, as in this case with a longitudinal pyramidal fracture. Figure comm_13d_n.jpg: 5-year-old boy with an unilaterally dripping nose due to a frontobasal fracture with laceration of the dura; the dripping is mainly observed in sitting position, the liquid is glucose-positive (= CSF). Figure comm_13e_n.jpg: 4-year-old boy with an otoliquorrhea on the right side; notice the bloody discolored fluid level in front of the auditory passage and the bloody spot with a brighter circle on the upper border of the swab.