Today’s image challenge is the case of a 25 years old male patient who presented with drowsiness and a forehead laceration after a road traffic accident. Some selected images from his CT scan are being shared. Which of the following best describes all the findings?
- Anterior skull-base fracture
- Depressed skull fracture
- Frontal contusions
- Depressed frontal skull fracture involving both tables of sinus and underlying contusions
- Frontal sinus fracture and frontal contusions
Congratulations to those who selected: depressed skull fracture involving both tables of sinus and underlying contusion.
It is important to identify all findings on a head CT scan after trauma because it impacts further management. A simple depressed skull fracture may be managed conservatively if the depression is less than the thickness of bone and does not cause any cosmetic deformity or deficits. But a depressed fracture of the frontal sinus involving both tables increases the risk of later CSF rhinorrhoea or meningitis and is thus often treated surgically. The frontal contusions are small but important findings because they may flare up and raise the intracranial pressure.