Disruption of skull continuity

Introduction Traumatic cranial continuous interruption is most common in skull fractures, which can be concave fractures, linear fractures, and cranial suture separation. A skull fracture is a disease in which one or more pieces of the head bone are partially or completely broken, mostly due to a blunt impact. Most of the skull structural changes do not require special treatment, but if accompanied by damage to the tissue structure in the skull near the force point, such as vascular rupture, brain or cranial nerve damage, meningeal tear, etc., it needs to be treated in time, otherwise it can cause intracranial Serious complications such as hematoma, impaired neurological function, intracranial infection and cerebrospinal fluid leakage affect prognosis.

Cause

The occurrence of a skull fracture is the result of the reaction force generated by the violence on the skull. If it is revealed that it moves in the direction of the violent action and does not form a reaction, it will not cause a fracture. Since the anti-stretching strength of the skull is always less than the compressive strength, when the violence is applied, the part that always bears the tension first breaks. If the striking area is small, the local shape of the skull is mostly changed to the main; if the area of the force is large, the overall deformation of the skull can be caused, often accompanied by extensive brain damage.

an examination

Related inspection

Brain CT examination of skull transillumination test for brain MRI

Can occur in any part of the skull, with the largest amount of parietal bone, followed by the frontal bone, followed by the humerus and occipital bone. Generally, the fracture line does not cross the cranial suture. If the violence is too large, it can also affect the adjacent bone. The positive lateral position of the skull can be diagnosed. X-ray and CT examinations are sometimes difficult to find skull base fractures. The diagnosis mainly depends on the clinical characteristics of the injured local blood stasis, cerebrospinal fluid leakage and nerve injury.

Differential diagnosis

Differential diagnosis of continuous cranial interruption:

1. Skull lesions: Bone lesions are almost common in all Langerhans cell histiocytosis patients. Individual bone lesions have more bone lesions, mainly manifested as osteolytic lesions. Skull lesions are most common, followed by lower extremity bones, ribs, pelvis and spine, and jaw lesions are also quite common.

2. Skull fracture: The skull is a spherical shell that accommodates and protects the contents of the cranial cavity. The importance of skull fractures is not in the skull fracture itself, but in the concurrent damage of the cranial cavity. According to the shape of the fracture, it is classified into: linear fracture, depressed fracture, comminuted fracture, and child growth fracture. A fractured piece of a depressed or comminuted fracture can damage the meninges and brain and damage the cerebral blood vessels and cranial nerves. Skull fractures account for about 15-20% of craniocerebral injury, which can occur in any part of the skull, with the largest amount of parietal bone, followed by the frontal bone, followed by the humerus and occipital bone. Generally, the fracture line does not cross the cranial suture. If the violence is too large, it can also affect the adjacent bone. The positive lateral position of the skull can be diagnosed. Because of the different fracture morphology, the treatment and prognosis are also different.

3, huge skull defects: skull defects are mostly caused by open craniocerebral injury or firearm penetrating injury, some patients are residual bone defects due to surgical decompression or diseased skull resection. In recent years, due to the high brain pressure of severe craniocerebral injury, the decompressive method of decompressive craniectomy is prevalent, so there are many artificial large skull defects. In fact, a considerable number of patients do not need large cranial decompression. Most of them are decisions made during the surgery, and there are no defects. Can occur in any part of the skull, with the largest amount of parietal bone, followed by the frontal bone, followed by the humerus and occipital bone. Generally, the fracture line does not cross the cranial suture. If the violence is too large, it can also affect the adjacent bone. The positive lateral position of the skull can be diagnosed. X-ray and CT examinations are sometimes difficult to find skull base fractures. The diagnosis mainly depends on the clinical characteristics of the injured local blood stasis, cerebrospinal fluid leakage and nerve injury.

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