Last reviewed: October 2017
Last updated: September  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • open fracture
  • palpable discrepancy in bone contour
  • Battle's sign
  • periorbital ecchymosis
  • bloody otorrhoea
  • CSF rhinorrhoea
  • facial paralysis, nystagmus, or paraesthesia

Other diagnostic factors

  • evidence of trauma
  • cranial pain or headache
  • nausea
  • altered mental state/loss of consciousness
  • abnormal pupillary reflexes
  • hearing loss

Risk factors

  • male sex
  • fall from height
  • motor vehicle accident (MVA)
  • assault resulting in head trauma
  • gunshots to the head

Diagnostic investigations

Investigations to consider

  • MRI
  • MR angiography
  • beta-2 transferrin assay
  • audiogram
  • cranial ultrasound
  • plain skull x-ray
  • skeletal survey
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Demetrios Demetriades

Professor of Surgery

Director

Division of Trauma and Surgical Intensive Care

LAC+USC Trauma Center

Keck School of Medicine at USC

University of Southern California

Los Angeles

CA

Disclosures

DD declares that he has no competing interests.

Leslie Kobayashi

Associate Professor of Surgery

Division of Trauma, Surgical Critical Care and Burns

University of California San Diego

San Diego

CA

Disclosures

LK declares that she has no competing interests.

Peer reviewers VIEW ALL

Consultant and Honorary Senior Lecturer in Emergency Medicine

Clinical Lead

Emergency Department

Director of Medical Education

King's College Hospital

London

UK

Disclosures

TL declares that he has no competing interests.

Program Director

LSU Emergency Medicine Residency

Louisiana State University

New Orleans

LA

Disclosures

MJH declares that she has no competing interests.

Physician in Chief

R Adams Cowley Shock Trauma Center

Francis X. Kelly Professor of Trauma Surgery

University of Maryland School of Medicine

Baltimore

MD

Disclosures

TS declares that he has no competing interests.

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