Fracture of base of the skull
The fracture of base of the skull represents the hardest injury which is followed by a fracture of one or several 
bones entering foundation of brain department of a skull – occipital, temporal, trellised, wedge-shaped.
Similar damages statistically meet seldom, making only 4% of number of severe craniocereberal injuries, and voznikayutchashche vseg result of a car accident, falling from the big height, and also strong blows in a nose or a mandible.
The fracture of base of the skull is followed by damage of covers of a brain that causes the expiration of cerebrospinal fluid (liquor) through nasal and oral cavities, an eye-socket, a tympanic cavity. In most cases it leads to emergence of a posttravmaticheskoypnevmotsefaliya - to infection of intracranial contents due to penetration of activators.
Anatomy of a fracture of base of the skull
Fractures of base of the skull are subdivided a napovrezhdeniya of front and back parts of its basis. Injuries of temporal, occipital and back parts of wedge-shaped bones belong to the first type of changes. To the second - fractures of trellised and wedge-shaped bones. The most widespread of them is the fracture of a temporal bone (more than in 75% of cases), depending on an arrangement of the line of damage of rather longitudinal axis of a pyramid of a temporal bone can be cross, longitudinal and mixed.
Fractures of an occipital bone are accompanied by high risk of damage of large blood vessels, nerves and a spinal cord. Damages of cranial nerves are fraught with paralysis of oculomotor and facial nerves or a hearing loss owing to an eighth cranial nerve injury.
Symptoms of a fracture of base of the skull are:
- Bleeding from ears or a nose;
- The expiration of liquor from ears (отоликворея) or a nose (риноликворея);
- Accumulation of blood allocations in a drum cavity;
- Symptom of "points" (so-called, "eyes of a raccoon") - an okologlaznichny ecchymoma;
- Symptom of Bettla-ekhimoz in the field of a mastoid of a temporal bone;
- Vomiting, nystagmus, hearing disorder;
- Vision disorders - in case of jamming by the broken bones of an optic nerve;
- Disturbances of the vital functions: hemodynamics, breath.
Effects of a fracture of base of the skull
The fracture of base of the skull is a most dangerous injury, pernicious both for head, and for a spinal cord as the base of skull is the combining link of all central nervous system of the person. Effects of a fracture of base of the skull can be various, beginning from a small rachiocampsis, frequent 
headaches, the increase in arterial pressure which is not giving in to control, finishing with meningitis, encephalitis, full paralysis of a body or death.
Quality of life of the victim who transferred a fracture of base of the skull depends on character and weight of a craniocereberal injury, existence of infection of a meninx, the accompanying pathologies.
Treatment of a fracture of base of the skull
Patients have to perform treatment of a fracture of base of the skull in neurosurgical department of hospital. Distinguish conservative and operational methods of treatment. The leading role in a conservative method of treatment is occupied by prevention of intracranial complications for what at once after arrival of the patient in a hospital intravenous, intramuscular, endolumbar or subarachnoidal administration of drugs antibiotics of a broad spectrum of activity is appointed.
In cases of emergence of the pressed getting defeats of a side and front parabasal sine, multisplintered change of a front cranial pole conservative treatment is senseless. Surgical methods also treat a recurrence of an intracranial purulent complication, назальнаяликворея. However in each separate case the decision on need of surgical intervention is made by the experienced neurosurgeon.
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