Monday, July 14, 2014

Skulls and Crossbones I

This patient is found down in a park and brought to the emergency department. He is complaining of headache, nausea, and vomiting. He has a cranial nerve III palsy. A few days after the trauma, this patient develops otorrhea and rhinorrhea.

Challenge: What's the diagnosis?

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jimmy said...

basilar skull Fx with battles sign + other

Craig Chen said...

good recognition!
Skulls and Crossbones I

Basilar skull fractures involve at least one of the five bones at the base of the skull: cribiform plate of the ethmoid, orbital plate of the frontal, petrous and squamous portion of the temporal, and the sphenoid and occipital bones. Otorrhea or rhinorrhea results from a dural tear leading to a CSF leak. The images show Battle sign (retroauricular or mastoid ecchymoses) and racoon eyes (periorbital ecchymoses).

Source: UpToDate.