Temporal bone fractures. Types of temporal bone injuries

Causes and course of the disease. This type Trauma is now a fairly rare occurrence. Pyramid fracture temporal bone may develop as a result of:

Injuries to the skull bones;

Fracture of the base of the skull;

Injury to the chin caused by falling on it and hitting a hard object.

Clinical picture.

Longitudinal fracture of the temporal bone are characterized by the fact that as a result of injury a fracture occurs in the area of the upper bone parts external auditory canal and disruption of integrity tympanic cavity. The cause of this fracture is a lateral injury to the skull.

With a longitudinal fracture, the main symptoms are:

Bleeding from the external auditory canal;

Gap eardrum;

Almost complete preservation of hearing;

Full functionality preserved vestibular apparatus;

Discharge of cerebrospinal fluid (CSF) from the ear canal.

Transverse fracture of the temporal bone- this is a fracture where the fracture line is located across the pyramid of the temporal bone. The cause of this damage is trauma to the frontal or occipital part of the skull.

With a transverse fracture, the main symptoms are:

Job inner ear severely disrupted;

No bleeding from the external auditory canal;

Paralysis or paresis of the facial nerve on the affected side.

Diagnostics. In accordance with the above symptoms of the disease, we can determine what type of temporal bone fracture we are dealing with: longitudinal or transverse. Also additional methods studies allow an accurate diagnosis.

X-ray of the temporal bones according to Schüller, Mayer and Stenvers, as well as CT scan temporal bones.

Radiation diagnostics of the temporal bones makes it possible to much more accurately determine the type of fracture of the temporal bone pyramid, as well as its location and the total extent of damage to the bones of the skull.

Lumbar (spinal) puncture.

Cerebrospinal fluid is collected in lumbar region. It is carried out in order to exclude the addition of various infections, which can significantly complicate the course of the underlying disease (injury).

Otoscopic examination of the ear and videotomicroscopic examination of the ear.

Ear examination included medical standard examinations of each ENT patient, for any condition and diagnosis. In this case, this study should be carried out to clarify this difficult diagnosis. The fact is that bloody issues from the ear are not always the result of a fracture of the pyramid of the temporal bone. Sometimes they can be a consequence of bullous post-influenza otitis, or inflammation based on an infectious nature.

Treatment.

First aid and transportation to an ENT hospital.

When receiving this injury, it is necessary to stop any movement or movement of the victim’s head so that the situation does not worsen. When moving a patient to the intensive care unit of a hospital, it is necessary to avoid any “shocks”, body movements, and changes in head position.

Treatment in a hospital.

Treatment tactics in an ENT hospital are determined depending on the condition of the patient, who in addition to the hearing organs in most cases also has a central injury nervous system. As a rule, an operative (surgical) treatment route is chosen, followed by antibacterial, desensitizing and symptomatic therapy.

Prevention There is no fracture of the pyramid of the temporal bone, since possible injury cannot be predicted. The only way a person can protect himself is to use a helmet when riding a motorcycle, bicycle, and a special construction helmet when at a construction site.

Fractures of the base of the skull are among the most dangerous and severe injuries. They are more often observed in leading active image the lives of young or middle-aged people and socially disadvantaged people. These injuries account for 4% of total number(traumatic brain injury).

The causes of such fractures can be direct blows to lower jaw or to the head, traffic accidents, sports (especially extreme sports), falling from a height, emergency situations in production, etc. In this article we will introduce you to the types, symptoms, methods of providing first aid, treatment methods and consequences of such injuries. This information will be useful to you, and you will be able to provide timely and correct necessary help the victim, increasing his chances of a favorable outcome of the fracture.

With such injuries, a fracture of the occipital, sphenoid, ethmoid or temporal bone occurs. The danger of these injuries lies not only in broken bones, but also high risk violation of the integrity of nearby organs. The close location of such important organs for ensuring vital functions as the head and spinal cord, determines the inclusion of such fractures in the emergency response list, since their occurrence almost always poses a threat to life. A fracture of the base of the skull can be an independent injury or combined with damage to the bones of the vault (in approximately 50-60% of cases).

Classification

By their nature, fractures of the cranial vault are divided into:

linear - the bone fracture is a thin line and is not accompanied by displacement of fragments, such injuries are the least dangerous, but may be accompanied by the appearance of epidural hematomas and damage to the vessels of the meninges;
splintered - when a fracture occurs, several fragments are formed that can injure the membranes and tissues of the brain (brain crush, subdural and intracerebral hematomas);
depressed - the fragment is pressed (immersed) into the cranial cavity and causes the same damage as a comminuted fracture.

Based on location, such injuries are divided into fractures:

front cranial fossa;
middle cranial fossa;
posterior cranial fossa.

According to various statistics, in 50-70% of cases fractures occur in the area of the middle cranial fossa. Depending on the nature of the fault line, they can be transverse, longitudinal or oblique.

Mechanisms of damage

Fractures of the bones of the base of the skull are in almost all cases accompanied by rupture of the dura mater of the brain. In this case, communication occurs in the mouth, nose, paranasal sinuses nose, middle ear and eye socket with air external environment. It can lead to the entry of microbial agents and infection of brain tissue, the appearance of post-traumatic pneumocephalus and the leakage of cerebrospinal fluid from the ears and nose (auricular and nasal liquorrhea).

With fractures of the anterior cranial fossa, hemorrhage occurs in the tissue of the periorbital tissue (“symptom of glasses” or “raccoon eyes”). When a perforated plate and cells break ethmoid bone Cerebrospinal fluid may leak through the nose and, in some cases, subcutaneous emphysema develops.

With some fractures of this part of the skull, damage to the visual, oculomotor and olfactory nerves. Such injuries may be accompanied by concomitant injuries to the diencephalic parts of the brain.

Symptoms

The severity and nature of symptoms in fractures of this part of the skull depend on the location of the fracture and the degree of damage to the brain structures. At the time of injury, the victim loses consciousness. Its duration depends on the severity of the injury - it can be expressed in short-term fainting or prolonged coma. When forming intracranial hematoma before loss of consciousness there may be a short period of enlightenment, which should not be mistaken for sign of mild injuries.

Common signs of a basal skull fracture are the following:

bursting, arising due to progressive cerebral edema;
"symptom of glasses";
different pupil diameters;
pupils do not react to light;
vomit;
nasal or ear liquorrhea (with blood);
involuntary urination;
disorders of the heart: slowing or increasing heart rate, arterial hypo- or hypertension;
confusion;
agitation or immobility;
circulatory and respiratory disorders (due to compression of the brain stem).

Fractures of the pyramid of the temporal bone

With such injuries, faults can be longitudinal, transverse, diagonal, and with apical separations. A transverse fracture provokes paralysis of the facial nerve, disturbances in the functioning of the vestibular apparatus, and complete loss of hearing and taste. With longitudinal fractures, the facial nerve canal, inner and middle ear are damaged. In this case, partial hearing loss, rupture of the eardrum, bleeding and leakage of cerebrospinal fluid from the ear, hemorrhage in the area of the temporal muscle and behind the ear develop. When you try to turn your head, the bleeding becomes more intense. Therefore, such victims are strictly forbidden to turn their heads.

Anterior cranial fossa fractures

Such injuries are accompanied by nosebleeds and nasal liquorrhea. After 2-3 days, the “symptom of glasses” appears. When the cells of the ethmoid bone are broken, subcutaneous emphysema develops and blisters form on the skin.

Middle cranial fossa fractures

Such injuries are accompanied by the development of unilateral auricular liquorrhea, which develops as a result of rupture of the eardrum, and unilateral bleeding from the ear. The victim's hearing sharply decreases or disappears completely, bruises appear in the area of the temporal muscle and behind the ear, the functions of the facial nerve and taste sensations are disrupted.

Posterior fossa fractures

With such fractures, the victim develops bruises behind one or both ears, and there are disturbances in the functions of the facial, abducens and auditory nerves. The victims' vital functions are disrupted important organs. When the caudal nerves are ruptured or pinched, paralysis of the tongue, larynx and palate develops.

First aid

The outcome of such injuries largely depends on the correct provision of first aid. If you suspect such damage, you should immediately call an ambulance. After this, the following activities must be carried out:

Place the victim on his back without a pillow. The body must be immobilized by fixing it top part and head.
If the victim has lost consciousness, then he should be placed on his back, but with a half-turn (place a cushion of clothing under the body), and his head should be tilted to the side to prevent choking on vomit.
Treat the head wound with an antiseptic and apply an aseptic bandage with a sterile bandage.
Remove dentures, jewelry and glasses.
Unfasten clothing that restricts breathing and blood circulation.
With absence respiratory disorders the victim can be given to take Analgin with Diphenhydramine.
Apply cold to your head.

After the ambulance arrives and during transportation to medical institution the following activities are carried out:

Diuretics (Lasix), drugs to support cardiac activity (Sulfocamphocaine, Cordiamin) and glucose solution are administered. In case of massive bleeding, a solution of Gelatinol or Polyglucin is administered instead of a diuretic.
If there are signs of respiratory distress, oxygen is inhaled through a mask.
When motor excitation appears, Suprastin is administered.
The use of painkillers can be done with caution and only in the absence of massive bleeding and respiratory problems. The use of narcotic analgesics is excluded, since they can provoke respiratory disorders.

Which doctor should I contact?

If you suspect a fracture of the bones of the base of the skull, you must call an ambulance and take the patient to a medical facility. In the future, he will need treatment from a neurosurgeon and consultation with a neurologist, otolaryngologist and ophthalmologist. To clarify the diagnosis, radiography, CT and MRI are prescribed.

Diagnostics

For any traumatic brain injury, an examination is required to identify fractures of the base of the skull. Medical examination includes:

examination and interview of the victim;
determining the circumstances of the injury;
neurological examination;
examination of the pupils;
identifying the presence of tongue deviations from midline and the symmetry of the grin of the teeth;
pulse examination.

After this, the following instrumental studies are carried out:

radiography of the skull (images are taken in two projections);

Treatment

Treatment of skull base fractures should be carried out in the neurosurgical department with the participation of a neurologist, ophthalmologist and otolaryngologist. In the early stages, antibiotics are prescribed to prevent the development of purulent complications. wide range action, the nasopharynx and middle ear are sanitized (they instill antibacterial agents). With the development of purulent processes, additional endolumbar administration of antibiotics is performed (into the subarachnoid space). For this, Kanamycin, Monomycin, Polymyxin or a drug selected after analysis (culture) to determine the sensitivity of the flora to a particular drug can be used. The material for such an analysis can be a sample of cerebrospinal fluid or a swab taken from the nasal mucosa.

Further treatment tactics are determined by the severity of the fracture; it can be conservative or surgical.

Conservative therapy

Conservative treatment methods can only be used for mild and moderately severe injuries, in which liquorrhea can be eliminated without surgery.

The patient is advised to adhere to strict bed rest with exalted position head, preventing the release of cerebrospinal fluid. To reduce swelling, the patient is prescribed dehydration therapy. To do this, every 2-3 days lumbar puncture(removal of cerebrospinal fluid from a puncture in the lumbar region) and the same volume of oxygen is injected into the subarachnoid space (subarachnoid insufflation). In addition, diuretics (Diacarb, Lasix) are prescribed to eliminate edema.

Surgery

Indications for neuro surgery are the following cases:

the presence of compression or damage to brain structures;
the presence of a comminuted fracture;
inability to stop liquorrhea from the nose using conservative methods;
relapses of purulent complications.

The above cases can pose a direct threat to life and can only be eliminated through surgery. To perform this, craniotomy is performed. After the intervention is completed, the open area of the skull is closed with a special plate or a section of previously removed bone. After such operations, the patient requires long-term rehabilitation, the program of which is compiled individually.

Consequences

The nature of the consequences for fractures of this part of the skull depends on their severity, the presence of purulent complications and concomitant diseases. The consequences of such injuries can be direct or long-term.

Direct consequences occur at the time of injury. These include:

formation - small accumulations of blood can resolve on their own, but large ones compress the brain tissue and require surgical removal;
damage to brain tissue - depending on the location of such damage, vision, hearing may be lost, or breathing may be impaired;
purulent complications – pathogenic microorganisms lead to the development or formation of abscesses.

Long-term consequences of such injuries develop some time after recovery. Typically this period ranges from several months to 5 years. The reason for their appearance is incomplete restoration of brain tissue or the formation of scars in the fracture area, which causes compression of blood vessels and nerves. Long-term consequences include the following complications.

Fractures of the cranial bones occur in children due to trauma much more often than in adults. The temporal bone, passing through the vault and base of the skull, is in fourth place in terms of frequency of damage - after the parietal, frontal and occipital bones. Inside it is the tympanic cavity, which is involved in the transmission of sound vibrations from the ear to the brain. Important blood vessels and nerves also pass through this bone.

A fracture of the temporal bone is distinguished primarily by a narrow line of damage, since with this injury the bone fragments are never displaced. An exception is possible only if there is a fracture in the scaly part, during which the fragments can move significantly. But still, this is the easiest of all possible fractures, which almost never requires surgical intervention.

All cases of fracture in this area are divided into three types: longitudinal, transverse, mixed. Longitudinal ones occur most often - up to 90% of cases.

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The main signs by which a longitudinal fracture can be recognized are as follows:

after an injury, blood flows from the ear. Sometimes cerebrospinal fluid (CSF) may flow instead of blood;
hearing deteriorates, but balance is not impaired. Much less often, complete deafness may occur;
after some time, as a result of swelling, facial paralysis may appear.

No manipulation of the child's ear before arrival medical care cannot be carried out. Bleeding can be very severe if the fracture is mastoid(in the lower part of the temporal bone) - only then it is necessary to insert a tight tampon, if possible made of sterile cotton wool. But rinsing the ear is under no circumstances allowed, as this is a direct route to infection.

There may not be any bleeding, but in this case a bruise appears under the skin behind the ear (Battle's symptom) - this is also an indication for seeking medical attention as soon as possible.

If after a head injury the child becomes completely deaf, has impaired balance, dizziness, vomits (optional) and immediately paralyzes half of the face on the side of the impact, this indicates a transverse fracture. The listed symptoms can be identified if the victim is conscious. But more often, after such damage, people lose consciousness for a long time - for several hours or even days. CSF leaks from the nose, but there is no discharge from the ear.

Mixed cases can be characterized by all of the listed symptoms - liquorrhea and bleeding in both the ears and nose, paralysis occurring immediately or later, etc.

Diagnosis and treatment

Information for curious parents:

The exact diagnosis of “temporal bone fracture” and the type of damage are established after careful radiography in at least three projections. In particular difficult cases you have to resort to computed tomography.

Having received such a fracture, it is necessary to be treated only inpatiently, under the continuous supervision of doctors. To treat a longitudinal fracture, therapy in three directions is most often sufficient:

bleeding or liquorrhea;

The ear is cleaned “dry”, using a cotton holder or a suction device. After cleaning, a sterile bandage is put on, which cannot be removed day or night. During the normal course of recovery, the discharge stops within a few days.

facial paralysis;

Treat with suppositories with glucocorticoids. Delayed paralysis responds well to medication and most often resolves as soon as the swelling subsides.

hearing impairment.

Deafness that occurs as a result of a longitudinal fracture is of a conductive nature, that is, caused by a violation of sound conduction - the connection of the auditory ossicles in the tympanic cavity is disrupted. Conductive deafness most often resolves spontaneously. In only one case out of four, hearing loss remains and can only be cured with the help of special operation- tympanoplasty.

Traumatic brain injury (TBI) is one of the most life-threatening situations that occurs when the skull is damaged. In more detail, each part of the brain is responsible for certain functions that help us adapt in society. The first place in the severity of the clinical picture is occupied by a fracture of the temporal bone.

A bone fracture is a violation of its integrity under the influence of external factors.A temporal bone fracture can be anatomically divided into the following types: transverse, longitudinal, atypical. The temporal part of the skull protects the temporal lobe of the brain from various types of damage, which performs a number of such important functions as perception and understanding oral speech, objects, sounds, and smells.

Causes of fractures in adults and children

The most common reasons that can cause such symptoms may be:

A blow to the head with a blunt or heavy object;
Fall (from height, motorcycle, stairs);
Various car accidents;
IN war time a cause such as a gunshot wound cannot be ruled out.

As for children, a fracture of the temporal bone in a child can occur for exactly the same reasons as in adults, however, sports injuries come first. The danger of such injuries is that further symptoms may appear after a while, when it will be very difficult to do anything about the child’s health. Therefore, if your child is injured, you should immediately consult a doctor to make sure that your child is not in danger.

Clinical signs in a child with a skull fracture appear quite quickly. Upon admission to the hospital: from the external ear canal cerebrospinal fluid is released, and subsequently the formation of adhesions and scars is observed. The formation of foci with necrosis is possible. Closed fracture The temporal bone is dangerous because in most cases the appearance of neurological symptoms is noted, due to the depth of indentation of bone fragments.

Signs and symptoms

The clinic of a temporal bone fracture will be characterized by a number of characteristic symptoms, which cannot be overlooked.

The following come to the fore:

Loss of coordination in space (the victim staggers, falls, leans on the wall, cannot stand straight);
Hearing acuity decreases (even to the point of deafness);
Battle's symptom is also identified.

Battle's sign is extensive hemorrhages in the postauricular area, they are characterized by irregular shape and a diameter of 5 mm or more. This symptom is accompanied by bleeding from the external auditory canal. In addition to bleeding in environment It happens internal bleeding. It leads to the formation of a hematoma.

In more difficult situations, it is possible to see cerebrospinal fluid flowing out of the ear canal. Paresis is not excluded facial nerves, and all due to the fact that conductive fibers nerve tissue pinched during a fracture. Basically this is 15-20% of all cases. It will be possible to diagnose sensorineural hearing loss.

If the fracture is not treated, then after a week the process progresses, and paralysis of the muscles on the face can be diagnosed. If the bones in the middle ear are damaged, a complication such as conductive hearing loss cannot be avoided.

Fracture mechanism: fragments damage adjacent membranes and medulla. The consequences in this case are very serious: loss of hearing and vision. The consequences listed above can be identified instantly. There are also long-term consequences.

They occur a few weeks later (can occur five years or more) after the victim has begun to recover. The reason for this may be: incomplete regeneration of nervous tissue at the site of injury or scar formation, and the nerves and vessels supplying the brain are compressed.

Consequences of a comminuted fracture:

Paralysis of facial muscles;
It is possible that encephalopathy may occur, as well as disruption of various functions (from disorientation in space to loss of self-care skills);
Development of epilepsy or epileptic seizures;
As it progresses, a cerebral stroke develops.

Fracture of the pyramid of the temporal bone

There are both longitudinal and transverse fractures of the pyramid of the temporal bone. The mechanism of injury is as follows: a fracture appears in the upper bony parts of the external auditory canal. The integrity of the tympanic cavity is compromised. Longitudinal occurs as a result of lateral injury. Peppered - due to injury in the frontal and occipital areas.

The symptoms of this fracture are as follows:

Hearing is completely preserved;
Bleeding into the environment from the ear;
Dizziness, unsteadiness of gait and the victim is absent;
Cerebrospinal fluid can be isolated from the ear canal along with blood.

Linear fracture of the temporal bone squama

In this situation, an artery rupture often occurs with the formation of a hematoma. Over time, a fracture of the temporal bone squama will manifest itself as focal epileptic seizures. Quite often, bleeding from the external auditory canal or nose, as well as positive meningeal symptoms, can be observed.

First aid for damage

The goal of first aid is to stop bleeding from the external auditory canal. It is necessary to make a tamponade with sterile cotton wool overlaying aseptic dressing. To deliver the victim to the hospital, he must be transported lying down and ensure complete immobility. In the hospital itself, when an increase in intracranial pressure, a lumbar puncture is indicated.

Rehabilitation and recovery

Complex rehabilitation is based on a combination of methods such as physiotherapy, psychotherapy, and intravascular detoxification treatment. Concerning drug treatment, then its goal is to improve and restore metabolic processes in the affected areas of the vestibular-auditory analyzer, as well as to relieve inflammatory processes.

Prescribed medications:

improving oxygen supply to tissues (Trental, Cavinton, Reopoliglucin solution);
improving healing processes (for example, vitamins C, B, E);
dehydration drugs (Manitol, Diacarb);
sedatives (motherwort);
antibiotics are used if a secondary bacterial infection is detected;
at acute period dizziness, Betaserc should be prescribed.

Together with medicines indicated for massage of the cervical-collar area or physiotherapy. If the patient has subjective noise, transcutaneous electrical stimulation is used. The course of treatment is up to ten sessions of 15-20 minutes.

To avoid such a situation, you need to remember one simple rule: wherever you are, you must remember and follow safety precautions (at work, at home, on the street, on the road in a car). Remember this and always warn your loved ones and children to be careful. Be healthy!

Consequences of injury

In general, the condition will depend entirely on the severity of the fracture itself. Combined injuries often result in instant death. Due to the extensive hematoma and its pressure on the brain, death occurs in the coming days. Rarely, the victim can fully recover.

Remains next symptoms in the form of headache, loss of coordination, deafness, and the appearance of epileptiform seizures. It is worth remembering that if the temporal bone is damaged, irreversible consequences of the injury may occur, which can make the victim disabled.

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Head injuries are among the most serious for human life and health, especially if the consequence is damage to the integrity of the skull. The consequences of a temporal bone fracture in a child can last a lifetime and be quite unpredictable.

A bone fracture often occurs due to the influence of some external factors. The temporal bone protects the temporal lobe of the brain, which is responsible for understanding speech, as well as the perception of objects, sounds and smells, from various damage.

The most common The causes of fractures are external influences:

Severe injury from a blunt object or something heavy.
A fall from a height, accompanied by a blow to the temporal region.

Also enough common cause Children get various sports injuries. The main danger of such injuries is that symptoms may extend over time, and the deterioration of the condition and various consequences may appear after quite a long period of time.

Considering that children are constantly growing and developing, it is possible to miss the time to eliminate the consequences and in the future it will be quite problematic to bring health back to normal.

It is for this reason that in the case of any injury, even the most insignificant at first glance, it is necessary to show the child to a specialist and make sure that there is no harm to life and health.

In case of severe injury, the first signs of a fracture will be obvious and quite frightening: the ear will discharge from the ear canal.

Symptoms

A temporal bone fracture is accompanied by a number of symptoms that cannot be missed. They say that the situation is serious and urgent need to contact a specialist to avoid serious problems with health in the future.

Symptoms depend on the type of injury and damage sustained. At the same time, the total clinical picture in severe cases it is similar.

First of all, they appear:

loss of spatial orientation, impaired movement and coordination;
hearing impairment;
Battle's symptom appears bleeding in the ear area under the skin accompanied by bleeding from the ear canal through a damaged eardrum;
express .

Hemorrhages in the ear area usually occur due to auricle And exceed 5 mm in size, most often have an irregular shape in appearance.

If you do not treat the fracture and do not try to improve the patient’s condition, paralysis of the facial muscles may develop.

Comminuted fracture

If the blow was strong enough, it may happen fracture with splinter formation. There is also a cerebral fracture.

Bone fragments violate the integrity of the tissue and nearby membranes.

With such an injury, there may be immediate symptoms that will remain for life: loss of vision and hearing.

Appears immediately after injury.

Also, after some time, side symptoms may appear.

The term is unlimited and even after three years, the consequences of the injury may occur- the reason for this is often the formation of scars and subsequent compression of blood vessels or incomplete regeneration of nerve tissues and fibers.

The main consequences of this type of fracture include:

Mimic paralysis.
Encephalopathy, spatial disorientation, loss of skills.
Epilepsy.
Stroke.

All these consequences can appear either simultaneously or gradually in accordance with the progression of the injury and developing pathology.

Fracture of the pyramid of the temporal bone

There are two types of this type of fracture:

longitudinal - formed as a result of lateral injury;
transverse - occurs after injury to the forehead or back of the head.

Trauma manifests itself as follows: ear canal disrupted by fracture of bone parts, and the destruction of the eardrum also occurs.

If the forehead is injured, it may also be obvious fracture of the ethmoid bone.

With such a fracture, the following symptoms most clearly appear:

Bleeding from the ear out into the environment.
The appearance of cerebrospinal fluid along with blood from the ear canal.
Hearing is preserved and not impaired.
There is no loss of coordination.

Temporal bone squamous fracture

With this type of fracture, a hematoma often forms due to rupture of the artery.

The most characteristic feature of this type of injury is a gradual increase in symptoms. epileptic seizures, as well as bleeding from the nose and ear and the manifestation of meningeal symptoms.

First aid

The main task of providing first aid is to ensure complete rest for the victim, as well as preventing infection from entering the site of possible damage.

To do this, when bleeding from the ear hole, first of all, you need to make a tamponade with sterile cotton wool or apply a clean and sterile bandage.

Any movement of the victim, including to the hospital, must be carried out in a supine position, ensuring complete immobility.

In the hospital itself, if increased intracranial pressure is detected, a lumbar puncture may be performed.

Treatment

Treatment is determined directly by a specialist when initial examination victim, because only a doctor can directly determine what a fracture looks like on an x-ray.

Depending on the patient’s condition, the degree and type of injury and the consequences developing against this background, it will be decided decision on the need and advisability of surgical intervention or drug therapy.

Surgical intervention can be performed in case of open craniocerebral injury, as well as for the purpose of repositioning bone fragments and removing foreign bodies.

Can also produce opening and pumping out intracranial hematomas.

The severity of the injury can be divided into the following:

First degree - the patient’s consciousness is clear and undisturbed, the brain works without failures, the nervous system and muscle functions not violated.
Second, there are neurological abnormalities, and a short-term loss of consciousness is possible.
Third degree - severe or irreversible disturbances in the functioning of the nervous system, in which the patient falls into a coma; disturbances in the structure of the brain are easily detected.

At the first stage of treatment, the patient restorative therapy may be prescribed, which contributes to the normalization of the condition, as well as necessary procedure pain relief.

General therapy involves a set of measures aimed at eliminating swelling of parts of the brain, as well as soft tissues.

Medicines are selected in such a way that recovery occurs as follows:

Relief of neurological symptoms. Group B, nootropics and neuroprotectors are prescribed.
Pain relief using narcotics and medications depending on the patient’s condition.
Eliminate nausea with antiemetic drugs.
If the victim’s behavior is inappropriate, sedatives are used - benzodiazepine tranquilizers or strong hypnotics.

After discharge from hospital the patient needs to be observed by a neurologist, as well as periodically undergo rehabilitation courses in case of chronic headaches and other disorders of the nervous system.

Rehabilitation

Comprehensive rehabilitation after the main treatment consists of a combination of intravascular treatment.

The purpose of drug maintenance of the body is to improve metabolism in the affected areas, as well as restoration of body functions and elimination of possible inflammation.

Among medicines, prescribed during periods of rehabilitation, we can highlight Trental, Cavinton, vitamin B complex, Manitor or Diacarb, as well as Betaserc.

Along with a course of drug therapy, it is necessary to undergo a course of massage and exercise therapy.

Conclusion

The article discusses the causes of a temporal bone fracture, clear symptoms, as well as methods necessary treatment this injury.