[Skull base fractures in childhood. The role of CT in the accuracy of diagnosis]

Abstract

The authors treated 51 patients suffering from basilar skull fractures between January 1995 and June 1997 following a newly initiated protocol. The effectiveness of recognizing these fractures increased to twice and a half after applying a complex (neurologic, otolaryngologic, ophthalmologic, X-ray and cranial CT) diagnostic examination. CT scans were performed at the slightest suspicion of basilar skull fracture since they provide far more information than the native skull X-ray. A close coherence was observed concerning clinical symptoms, potential complications and the manifested fractures, which helped to draw an exact therapeutical strategy and to prevent potential complications. The authors found X-ray gave satisfactory information only about fractures starting on the vault. In the studied period CT proved the basilar skull fracture in 40 (78%) cases out of the total 51. X-ray did it in only 4 (8%) cases and raised the suspicion of the vault fracture spreading to the cranial floor in 20 (39%) cases. CT did not prove the clinically supposed basilar skull fractures in only 11 (22%) cases compared to 27 (53%) by X-ray. After having consultation with radiologists examination methods were always determined by the clinical picture and the available technical conditions (helical technique, multiplan or 3D-reconstruction).