Trauma Scoring Systems and Skull Base Fractures

Revised Trauma Score (RTS)

• Composed of Glasgow Coma Scale, Systolic Blood Pressure, and Respiratory Rate.

Trauma and Injury Severity Score (TRISS)

• Comprised of Injury Severity Score (ISS), Revised Trauma Score (RTS), Age, and Mechanism of Injury (Blunt or Penetrating).

Mangled Extremity Severity Score (MESS)

• Considers:
  • Energy of the injury
  • Limb Ischemia
  • Shock
  • Age

Skull Base Fracture

• Anterior cranial fossa fracture is the most common, accounting for approximately 70% of cases.
• Middle cranial fossa fractures make up about 20%.
• Posterior cranial fossa fractures are the least common, representing about 5%.
• The frequency of skull base fractures is represented by the following: ACF > MCF > PCF.
• Anterior cranial fossa fractures are primarily associated with frontal bone involvement.
• Middle cranial fossa fractures often lead to temporal lobe contusion.
• Posterior cranial fossa injuries can result in occipital lobe contusion.

Regions of the Skull

• Anterior Fossa: 70%
• Central Skull Base: 25%
• Middle Fossa: 5%
• Posterior Fossa: 5%