Basilar Skull Fracture - Pathophysiology

Pathophysiology

Basilar skull fractures include breaks in the posterior skull base or anterior skull base. The former involve the occipital bone, temporal bone, and portions of the sphenoid bone; the latter, superior portions of the sphenoid and ethmoid bones. The temporal bone fracture is encountered in 75% of all basilar skull fractures and may be longitudinal, transverse or mixed, depending on the course of the fracture line in relation to the longitudinal axis of the pyramid.

Bones may be broken around the foramen magnum, the hole in the base of the skull through which the spinal cord exits and becomes the brain stem, creating the risk that blood vessels and nerves exiting the hole may be damaged.

Due to the proximity of the cranial nerves, injury to those nerves may occur. This can cause palsy of the facial nerve or oculomotor nerve or hearing loss due to damage of cranial nerve VIII.