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What is a Basilar Fracture?

By D. Jeffress
Updated May 17, 2024
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A basilar fracture is a linear break that occurs at the base of the skull, usually due to direct head trauma. Fractures to the skull base are especially dangerous, as a break can potentially rupture the protective membranes that surround the brain or damage the top of the spinal cord. A person who suffers a basilar fracture typically needs to be thoroughly examined by a team of specialists to determine the exact location and size of the break. Fractures can be difficult to treat surgically due to their location, and most patients are simply instructed to avoid intense physical activity for several months and receive regular checkups to ensure that complications do not arise.

An individual can suffer a basilar fracture after taking a bad fall, being in a car accident, or getting struck in the head by a forceful object. Several portions of skull can be affected by a basilar fracture, including the occipital region on the back of the head and the temporal regions on the sides. Besides intense local pain, common symptoms of basilar fractures include impaired senses of smell, hearing, and vision, difficulties balancing, and nausea.

A fracture can occasionally cause a tear in the meninges, the membranes that enclose the brain and protect it with cerebrospinal fluid (CSF). CSF begins to leak into the sinus cavities when the meninges are torn, leading to bruising under the eyes and blockages in the ear canals. A condition called CSF rhinorrhea can also occur in which CSF in the nasal sinuses drains and drips from the nose.

The cavity in the occipital region called the foramen magnum protects the top of the spinal cord where it meets the brain. A basilar fracture of the foramen magnum can depress nerves and vital blood vessels, leading to emergency conditions. A person can suffer severe motor movement impairment and facial palsy. The nerves that control vision become damaged or severed in some instances, and a fracture that puts excessive pressure on the spinal cord can result in death.

Most instances of basilar fractures do not impair neurological functioning, and are not considered serious medical emergencies. When a doctor suspects a basilar fracture, she typically will conduct an x-ray and a computerized tomography scan to see the extent of damage. Skull fractures tend to heal on their own in three months to one year, as long as patients take care not to suffer additional injuries. Some patients are fitted with protective neck braces to help them avoid accidents. Frequent follow-up visits usually are important to make sure that bones correctly heal.

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Discussion Comments
By burcinc — On Jul 10, 2012

@burcidi-- I'm not an expert on this. But I think that most of the time the fluid is absorbed by the brain and disappears on its own.

The major thing to worry about with a basilar fracture and leaking of CFS is meningitis. And also if there are hearing problems, or loss of other senses like taste, there might be something more serious going on for which the doctors will have to intervene.

But if they sent your nephew home, I'm sure his situation is not serious. Your sister should keep a close eye on the CFS and also check for meningitis symptoms. If he does develop meningitis, it is easily treatable with antibiotics as long as it is noticed early.

By burcidi — On Jul 09, 2012

My sister who lives in another state with her husband and son informed me over the phone that my nephew has a basilar fracture after falling badly on the playground. They apparently kept him in the ER for a couple of hours and sent him home after an x-ray and tomography.

I am shocked to hear that a fracture to the skull doesn't require any treatment. Shouldn't they have kept him at least for the night to see if he was okay?

My sister also said that he has leaking CFS but the doctor said not to worry about that and it will stop on its own in a few days. Only if it continues are they required to report back in.

I'm sure that the doctors know what they're doing, but to me, any skull fracture sounds like it would require medical attention for more than a few hours.

Has anyone here suffered from a basilar fracture and had a similar experience?

By candyquilt — On Jul 09, 2012
I learned in my anatomy lecture today that the nerves in our brain grow at a rate of one-fourth of an inch every month. It's thanks to this that we don't die every time we fracture our skull.

It's also how people with basilar fracture heal. Their nerves grow back and the skull/brain reconstructs what was damaged. Even the senses that were lost initially come back. I think this is really cool.

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