Neurology

Question 1

Basal skull fracture - presentation (7)

Answer 1

Basal skull fracture is a fracture of one of the bones of the skull.

Presentation:
- headache
- LoC
- Battle’s sign : mastoid bruising
- Panda/raccoon eyes: periorbital bruising
- bleeding from nose and ears - otoscopy
- CSF leakage from nose or ears
- CN palsy

Question 2

GCS

Eyes
Open spontaneously

Verbal
No verbal response to pain

Motor
Limbs remain flaccid

Answer 2

E4 V1 M1

6

Question 3

GCS

Eyes
No eye opening

Verbal
Correctly states name, location, date, and why they are here

Motor
Limbs push away with painful stimulus

Answer 3

E1 V5 M2

8

Question 4

GCS

Eyes
Eyes remain closed

Verbal
Correctly states name, location, date, and why they are here

Motor
Flexion to pain (decorticate)

Answer 4

E1 V5 M3

9

Question 5

Indication for CT head in head injury (9)

Answer 5

• LoC
• seizures
• reduced GCS
• amnesia
• vomiting
• focal neurological deficit
• signs of basal skull fracture: panda eyes, haematympanum, Battle’s sign, CSF leakage from ears/nose
• abnormal drowsiness
• open/depressed skull fracture