Radiologic Evaluation of Skull Base Trauma

The skull base extends from the crista galli and frontal bone anteriorly to the occipital squamosa posteriorly. Anteriorly, the roofs of the orbits and the cribriform plate make up the floor of the bony vault. The sphenoid bone, with its body medially and its wings laterally, delineates the floor of the middle cranial fossa. The petrous ridges separate the middle cranial fossa from the posterior fossa. They contain not only important neural and vascular structures, but also important sensory organs of the auditory and vestibular apparatus which control hearing and balance. The occipital squamosa and clivus surround the brainstem, while the walls and roof of the posterior fossa contain dural venous sinuses. Critical damage to these structures can be life-threatening. Thorough evaluation of trauma to the skull base depends upon a comprehensive knowledge of its anatomy, and the appropriate choice of radio-graphic technique in relation to the clinical setting.