小结
定义
病史和体格检查
关键诊断因素
- 危险因素
- 开放性骨折
- 可触及的骨轮廓差异
- 巴特尔体征
- 眶周瘀斑
- 血性耳漏
- 脑脊液鼻漏
- 面神经麻痹、眼球震颤或感觉异常
其他诊断因素
- 外伤证据
- 颅痛或头痛
- 恶心/呕吐
- 精神状态变化/意识丧失
- 瞳孔反射异常
- 听力损失
危险因素
- 从高处跌落
- 机动车辆事故
- 导致头部外伤的殴打
- 头部枪伤
- 男性
诊断性检查
首要检查
- 颅脑 CT
需考虑的检查
- 骨骼检查
- 磁共振成像 (MRI)
- MR 血管造影术
- β-2 转铁蛋白试验
- 颅骨 X 光平片
- 凝血筛查
治疗流程
疑似颅骨骨折（任意类型）
确诊闭合性非凹陷性骨折
确诊闭合性凹陷性骨折
确诊开放性骨折
持续性颅神经损伤或脑脊液漏
撰稿人
专家顾问
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
利益声明
DD declares that he has no competing interests.
Leslie Kobayashi, MD, FACS
Associate Professor of Surgery
Division of Trauma, Surgical Critical Care and Burns
University of California San Diego
San Diego
CA
利益声明
LK declares that she has no competing interests.
同行评议者
Kevin Tsang, MBBS, BSc (Hons), MRCS (Eng), FRCS (SN)
Consultant Neurosurgeon
Unit Training Lead and Clinical Teacher
Imperial College Healthcare NHS Trust
London
UK
利益声明
KT declares that he has no competing interests.
编辑
Tannaz Aliabadi-Oglesby
Lead Section Editor, BMJ Best Practice
利益声明
TAO declares that she has no competing interests.
Jo Haynes
Head of Editorial, BMJ Knowledge Centre
利益声明
JH declares that she has no competing interests.
Annabel Sidwell
Comorbidities Editor, BMJ Best Practice
利益声明
AS declares that she has no competing interests.
Adam Mitchell
Drug Editor, BMJ Best Practice
利益声明
AM declares that he has no competing interests.
鉴别诊断
- 颅内出血
- 儿童缝线
- 头颅血肿
更多 鉴别诊断指南
- 头部损伤：评估和早期管理
- 儿科颅脑外伤的临床实践指南
更多 指南医学计算器
格拉斯哥昏迷量表
更多 医学计算器
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明