10. What is Battle’s sign?
Correct answer: This is bruising over the suboccipital region; it develops a day or two after injury and indicates a skull fracture of the posterior fossa.
9. What are the physical signs of a fracture of the posterior fossa of the skull?
Correct answer: (1) Bruising over the suboccipital region, which develops after a day or two (Battle’s sign). (2) Cranial nerve injuries – IX, X and XI (rare).
8. What are the physical signs of a fracture of the middle fossa of the skull?
Correct answer: (1) Orbital haematoma. (2) Bleeding from the ear. (3) Cerebrospinal fluid otorrhoea (rare). (4) Cranial nerve injuries – nerves VII and VIII.
7. What are the physical signs of a fracture of the anterior fossa of the skull?
Correct answer: (1) Nasal bleeding. (2) Orbital haematoma. (3) Cerebrospinal fluid rhinorrhoea. (4) Cranial nerve injuries – nerves I to VI.
6. What specific type of protein is found in cerebrospinal fluid?
Correct answer: Tau protein.
5. What is the difference between the composition of cerebrospinal fluid and normal nasal secretion?
Correct answer: The cerebrospinal fluid is rich in glucose and low in mucin content (and positive for tau protein), compared with the normal nasal secretion, which contains no sugar and is rich in mucin.
4. What are the clinical features of fractures involving the paranasal air sinuses?
Correct answer: Fractures extending through any of the paranasal air sinuses (frontal, ethmoidal or sphenoid) communicate with the outside and are therefore compound (open) fractures, as the overlying dura is usually breached. This external communication may manifest as a runny…
3. What are the general classifications of the type of head injury?
Correct answer: Injuries are usefully classified according to the structures involved (scalp, skull and underlying brain) together with the mechanism of the injury, be it penetrating or blunt, and whether an acceleration/deceleration and/or a rotational brain injury occurred. In reality,…
2. What is the significance of a scalp injury?
Correct answer: Most scalp injuries are simple penetrating injuries, which are readily managed by debridement and suture. When the skull is also penetrated, the brain may be lacerated. However, if the injury occurred when the head was stationary, in the…
1. How are head injuries generally classified?
Correct answer: Injuries are usefully classified according to the structures involved (scalp, skull and underlying brain) together with the mechanism of the injury, be it penetrating or blunt, and whether an acceleration/deceleration and/or a rotational brain injury occurred.
