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Basilar Skull Fracture

Basilar skull fractures (Fig. 7.6) are normally bursting fractures, and the causal mechanisms are the same as in linear calvarial fractures, which often extend into the base or conversely start there because of the lower fracture tolerance which is the result of the numerous local weak points of the structure of the skull base. The causal load can be a fall to the ground or being driven over by the wheel of a vehicle, a blunt impact to the neck, mandibular or facial impact, or an impact to parts of the occiput and almost any type of diffuse impact to the vertex of the head.

Fig. 7.5a-f. Types of calvarial fractures. a Linear fracture caused caused) linear fractures, associated with e tissue laceration of the by broad contact violence on occasion of a vehicular accident; brain structures located beneath the center of impact; f Puppe's b, c depressed fracture caused by a blow with a hammer; d com- rule which gives information on the sequence of impacts (see bined fracture caused by a fall with circular bending fracture of text) the parietal and temporal parts of the skull and secondary (burst-

Fig. 7.5a-f. Types of calvarial fractures. a Linear fracture caused caused) linear fractures, associated with e tissue laceration of the by broad contact violence on occasion of a vehicular accident; brain structures located beneath the center of impact; f Puppe's b, c depressed fracture caused by a blow with a hammer; d com- rule which gives information on the sequence of impacts (see bined fracture caused by a fall with circular bending fracture of text) the parietal and temporal parts of the skull and secondary (burst-

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