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Fraturas cranianas

Last reviewed: 17 Aug 2025
Last updated: 23 Jul 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • fratura aberta
  • discrepância palpável no contorno do osso
  • sinal de Battle
  • equimose periorbital
  • otorreia sanguinolenta
  • rinorreia liquórica
  • paralisia facial, nistagmo ou parestesia
Full details

Other diagnostic factors

  • evidências de trauma
  • dor craniana ou cefaleia
  • náuseas
  • estado mental alterado/perda de consciência
  • reflexos pupilares anormais
  • perda auditiva
Full details

Risk factors

  • queda de altura
  • acidente com veículo automotor
  • agressão resultando em trauma cranioencefálico
  • ferimentos por arma de fogo na cabeça
  • sexo masculino
Full details

Diagnostic investigations

1st investigations to order

  • TC craniana
Full details

Investigations to consider

  • ensaio da beta-2-transferrina
  • ressonância nuclear magnética (RNM) cranioencefálica
  • angiografia por ressonância magnética (RM)
  • ultrassonografia craniana
  • radiografia simples do crânio
  • TC de coluna cervical
  • radiografia do esqueleto
  • angiotomografia
  • Angiotomografia venosa
Full details

Treatment algorithm

ACUTE

fratura sem afundamento fechada

fratura com afundamento fechada

fratura aberta

ONGOING

lesão persistente de nervo craniano ou vazamento do liquido cefalorraquidiano (LCR)

Contributors

Authors

Demetrios Demetriades, MD, PhD, FACS
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, MD, FACS
Leslie Kobayashi

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

Prof Sherard Austin Tatum, MD

Professor Otolaryngology and Pediatrics

SUNY Upstate Medical University

Syracuse

New York

Divulgaciones

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

Divulgaciones

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.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

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.Texto completo  Resumen

Artículos de referencia

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