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A 19-year-old man sustained a crush injury to his skull from a piece of heavy machinery. Although on initial assessment he readily followed commands, his mental status deteriorated and he required intubation for airway protection. He was rapidly transferred to our level 1 trauma center. An examination of his pupils at his arrival showed ptosis (Panel A) and anisocoria (Panel B), which aroused concern that there was uncal herniation. A high-resolution computed tomographic scan of his head did not show uncal herniation but, rather, revealed a complex fracture of the sella turcica (Panel C, arrow) and of the skull base . . . [Full Text of this Article] |
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