Skull fractures

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Last reviewed: 20 Aug 2025
Last updated: 18 Jun 2025

Summary

Definition

Анамнез и осмотр

Ключевые диагностические факторы

  • open fracture
  • palpable discrepancy in bone contour
  • Battle sign
  • periorbital ecchymosis
  • bloody otorrhea
  • cerebrospinal fluid rhinorrhea
  • facial paralysis, nystagmus, or paresthesia
Полная информация

Другие диагностические факторы

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

Факторы риска

  • fall from height
  • motor vehicle accident
  • assault resulting in head trauma
  • gunshots to the head
  • male sex
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • cranial CT
Полная информация

Исследования, проведение которых нужно рассмотреть

  • beta-2 transferrin assay
  • MRI brain
  • MR angiography
  • cranial ultrasound
  • plain skull x-ray
  • CT scan cervical spine
  • skeletal survey
  • CT angiogram
  • CT venogram
Полная информация

Алгоритм лечения

Острый

closed nondepressed fracture

closed depressed fracture

open fracture

ПРОДОЛЖЕНИЕ

persistent cranial nerve injury or CSF leakage

Составители

Эксперты-консультанты

Demetrios Demetriades, MD, PhD, FACS

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

Раскрытие информации

DD declares that he has no competing interests.

Leslie Kobayashi, MD, FACS

Professor of Surgery

Division of Trauma, Surgical Critical Care and Burns

University of California San Diego

San Diego

CA

Раскрытие информации

LK declares that she has no competing interests.

Рецензенты

Prof Sherard Austin Tatum, MD

Professor Otolaryngology and Pediatrics

SUNY Upstate Medical University

Syracuse

New York

Раскрытие информации

SAT declares that he has no competing interests.

Tunji Lasoye, FRCS, FCEM, MA, Med Ed

Consultant and Honorary Senior Lecturer in Emergency Medicine

Clinical Lead

Emergency Department

Director of Medical Education

King's College Hospital

London

UK

Раскрытие информации

TL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

Expert Panel on Neurological Imaging: Shih RY, Burns J, et al. ACR Appropriateness Criteria® head trauma: 2021 update. J Am Coll Radiol. 2021 May;18(5S):S13-36.Полный текст  Аннотация

Статьи, указанные как источники

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