Neuroradiology
Teaching FileNeuroradiology
Teaching File
Findings :There is a linear fracture of the left temporal bone extending from the middle cranial fossa to the posterior fossa. The mastoid air cells on the left are partially opacified. A fluid level is seen in the sphenoid sinus. There is partial opacification of the ethmoid sinuses.
Discussion: Patients with a temporal bone fracture may present with a conductive hearing loss due to dislocations in the ossicular chain. Facial nerve paralysis occurs in 25-50% of cases, secondary to either transection or edema of the facial nerve.
Skull base fractures can be subtle. A fluid level in the sphenoid sinus or opacification of the mastoid air cells in the appropriate clinical setting are indicative of a fracture.
Reference: Harris J, Harris W, Novelline R: Skull and Brain. In The Radiology of Emergency Medicine, pp 8-10, Baltimore: Williams & Wilkins, 1993.
Case prepared by Steven Lee, M.D. and Anthony L. Alcantara, M.D.