====== Occipital skull fracture ======
[[Skull fracture]] of the [[occipital bone]].

{{::occipitalfractureleftlinear.jpg|}}

===== Case series =====

One hundred thirty-four cases of [[occipital]] skull fracture seen over the past 15 years at the Medical Center Hospital of [[Vermont]] have been analyzed with respect to their clinical course and neurologic [[outcome]]. Among the cases reviewed, one third of [[patient]]s had an uncomplicated course, 24% recovered with mild neurologic findings (such as [[cranial nerve palsy]]), and 13% died as a result of neurologic insult. This high [[morbidity]] results from combinations of [[traumatic subarachnoid hemorrhage]], [[Coup contrecoup injury]], and injury at the [[skull base]]. [[Posterior fossa hematoma]], [[cerebellar contusion]], parietal and [[occipital lobe]] [[injury]], and [[cranial nerve]] [[injury]] associated with this lesion are discussed in detail. CAT scanning is now part of there diagnostic routine in patients with occipital fracture in coma grades 1-5 ([[Grady coma scale]])
((Young HA, Schmidek HH. Complications accompanying occipital skull fracture. J 
Trauma. 1982 Nov;22(11):914-20. PubMed PMID: 7143497.
)).

===== Case reports =====

[[Depressed skull fracture]]s overlying the major [[venous sinus]] are often managed nonoperatively because of the high associated [[risk]]s of surgery in these locations. In the presence of clinical and radiographic evidence of [[sinus]] occlusion, however, surgical therapy may be necessary. 

Vender and Bierbrauer presented the case of a 9-year-old boy with a depressed skull fracture overlying the posterior third of the superior sagittal sinus. After initial conservative treatment, delayed signs of intracranial hypertension and a symptomatic tonsillar herniation with tonsillar necrosis developed. Possible causes as well as diagnostic and treatment options are reviewed
((Vender JR, Bierbrauer K. Delayed intracranial hypertension and cerebellar
tonsillar necrosis associated with a depressed occipital skull fracture
compressing the superior sagittal sinus. Case report. J Neurosurg. 2005 Nov;103(5
Suppl):458-61. PubMed PMID: 16302621.
)).
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[[Depressed]] occipital skull fracture with associated sagittal sinus occlusion
((Meltzer H, LoSasso B, Sobo EJ. Depressed occipital skull fracture with
associated sagittal sinus occlusion. J Trauma. 2000 Nov;49(5):981. PubMed PMID:
11086800.
)).