The Relationship of Signs and Symptoms and Complications of Skull Base Fractures with Skull Base CT Scan Findings

Background: Skull base fracture is diagnosed with high accuracy by skull base CT scan, but sometimes, due to the patient's general condition, CT scan cannot be performed. The aim of this study was to investigate the predictive value of signs and symptoms of skull base fracture in predicting the incidence of skull base fracture complications. Moreover, the relationship of clinical signs and symptoms and complications of skull base fracture with fracture line in conventional brain CT scan was investigated. Methods: In this study, 132 patients referred to the emergency department of one of the teaching hospitals in Kerman/ Iran who had signs and symptoms of skull base fracture were included. All patients underwent clinical examination and then conventional brain CT scan. During hospitalization period and one month after the admission, patients were followed for complications of skull base fracture. Data were analyzed using SPSS. Results: The most common clinical signs and symptoms included bruising around the eye, epistaxis and bloody discharge from the ear and the most common complications were pneumocephalus, cranial nerve palsy and rhinorrhea. There was no significant relationship between the presence of fracture line in conventional brain CT scan and clinical signs and symptoms of skull base fracture, but patients whose conventional brain CT showed fracture line, experienced more complications. Conclusion: Fracture line in conventional brain CT scan shows more probability of complications of skull base fracture. Hemotympanum increases cranial nerve palsy, and bruising around the eye significantly less associated with otorrhea. Clinical signs ofhemotympanum and fracture line in conventional brain CT scan had high predictive value in predicting respectively the incidence of cranial nerve palsy and the incidence of skull base fracture overall complications. Keywords Basilar Skull Fracture; Computed Tomography; signs and symptoms; complication